Disclosure Intervention for Zimbabwean Parents

对津巴布韦家长的披露干预

基本信息

批准号：
8537966
负责人：
Marguerita A. Lightfoot
金额：
$ 28.8万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
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：
2012-09-01 至 2017-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8537966
关键词：
17 year old AIDS/HIV problem Acquired Immunodeficiency Syndrome Address Adult Affect Africa South of the Sahara Anti-Retroviral Agents Anxiety Area Attention Behavioral Cessation of life Child Child Custody Childhood Country Developing Countries Dietary Intervention Disclosure Emotional Environment Family Family Relationship Frequencies Fright Guidelines HIV HIV Seropositivity Health Status Income International Intervention Knowledge Left Life Low income Medical Mental Depression Modeling Motivation Nurses Outcome Parents Policies Population Prevalence Problem behavior Randomized Randomized Controlled Trials Reaction Recommendation Risk Risk Behaviors Social support South Africa Stress Time Treatment Efficacy Zimbabwe affection aged base child depression cohesion improved neglect nutrition pediatric human immunodeficiency virus psychologic response social transmission process willingness

项目摘要

DESCRIPTION (provided by applicant): We propose a randomized controlled trial of a disclosure intervention in which 300 PLH are randomized to either an: 1) experimental condition, a disclosure intervention (n = 150 parents) or 2) attention control condition, a nutrition intervention (n = 150). The intervention's impact will be assessed over two years (recruitment, 3, 6, 12, 18, & 24 months). The 3-session, culturally tailored disclosure intervention will be delivered by local nurses and address planning for developmentally appropriate disclosure (how and when to disclose), responding to children's reactions, building a supportive family environment, and custody planning. The attention control condition will be relevant to PLH, also delivered by nurses and address nutrition. Therefore, the Specific Aims are to: 1) Primary Aim: Assess the efficacy of the intervention to increase the frequency and timing of parental disclosure. We hypothesize that PLH randomized to the disclosure intervention will be significantly more likely to disclose their own HIV status to their children (parental disclosure) and disclose sooner than PLH randomized to the control condition. 2) Primary Aim: Assess the longitudinal impact of disclosure on parent (medical, psychological, social), child (psychological, behavioral, social) and family outcomes. We hypothesize that parent (health status, depression, anxiety, social support), child (depression, anxiety, HIV-transmission risk behaviors, social support) and family outcomes (family relationships, custody planning) will be significantly better for families in the intervention than families randomized to the control condition. 3) Secondary Aim: Assess the efficacy of the intervention to increase pediatric disclosure. We hypothesize that PLH randomized to the disclosure intervention will be significantly more likely to disclose to a child that s/he is HIV-positive (pediatric disclosure) than PLH randomized to the control condition. The proposed study addresses a neglected and profoundly understudied area that is of high importance to millions of families affected by HIV. If successful, the proposed study will provide evidence for a sustainable model and efficacious disclosure intervention in low-income settings.

描述（由申请人提供）：我们提出一项公开干预的随机对照试验，其中 300 名 PLH 被随机分配到以下任一组：1) 实验条件、公开干预（n = 150 名家长）或 2) 注意力控制条件、营养干预（n = 150）。干预措施的影响将在两年内进行评估（招募、3、6、12、18 和 24 个月）。为期 3 次的、根据文化定制的披露干预措施将由当地护士提供，并解决适合发展的披露规划（如何以及何时披露）、响应儿童的反应、建立支持性的家庭环境以及监护规划。注意力控制条件将与 PLH 相关，也由护士提供并解决营养问题。因此，具体目标是： 1) 主要目标：评估干预措施的有效性，以增加家长披露的频率和时间。我们假设，随机分配到披露干预的 PLH 更有可能向其孩子披露自己的 HIV 状况（父母披露），并且比随机分配到对照条件的 PLH 更早披露。 2) 主要目标：评估披露对父母（医学、心理、社会）、儿童（心理、社会）的纵向影响。行为、社会）和家庭结果。我们假设，对于参与干预的家庭来说，父母（健康状况、抑郁、焦虑、社会支持）、孩子（抑郁、焦虑、艾滋病毒传播风险行为、社会支持）和家庭结果（家庭关系、监护计划）将显着改善比随机分配到对照条件的家庭要多。 3) 次要目标：评估增加儿科信息披露的干预措施的有效性。我们假设随机接受披露干预的 PLH 更有可能向一个他/她 HIV 阳性的儿童（儿科披露）比 PLH 随机分配到对照条件。拟议的研究涉及一个被忽视和充分研究的领域，该领域对于数百万受艾滋病毒影响的家庭非常重要。如果成功，拟议的研究将为低收入环境中的可持续模式和有效的披露干预提供证据。