Paper
Saturday, July 14, 2007
Translation of an Evidence-Based Behavioral Intervention for AIDS Patients
Jane Dimmitt Champion, PhD, FNP, CS, FAAN, Department of Family Nursing Care, The Univ of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| Learning Objective #1: describe the process for translation of an evidence-based cognitive behavioral intervention for a community health program. |
| Learning Objective #2: describe the results of translation of an evidence-based cognitive behavioral intervention for a community health program for individuals with AIDS. |
Background: This study builds on behavioral interventions developed in our previous studies. These studies are culturally relevant minority-gender-specific interventions based upon the AIDS Risk Reduction Model shown to be effective through controlled randomized trials. These interventions grounded in knowledge of the target populations’ behavior and culture use STI and measures of sexual behavior as primary outcome variables. Results of these trials with one, two and five year follow-ups demonstrated participants receiving intervention were significantly less likely to be re-infected with STI and report sexual risk behavior or depression. Mixed methods were used for translation of these interventions for community health programs. This study focuses on reducing rates of STI, unintended pregnancy and substance use among patients with AIDS who were lost to follow-up care by changing high-risk sexual behaviors, encouraging contraception and decreasing substance use.
Methods: A modified cognitive-behavioral intervention was pre-tested prior to implementation in a community health program to identify patients with AIDS who are lost to follow-up. Mexican-and African-American and non-Hispanic white women and men with AIDS who were lost to follow-up care were enrolled in a quasi-experimental study with scheduled 6 and 12 month follow-ups. Following study entry, participants attended the behavioral intervention and received case management for identification of necessary health and social services to promote patient re-entry into the health care system.
Results: Findings indicated overall high levels of substance use, abuse, depression and psychological distress. Intervention attendees versus non-attendees reported greater depression, symptom severity, and substance use. However, trends at 6 months follow-up indicated lower substance use, sexual risk behaviors, less depression and fewer symptoms for persons who attended the intervention.
Conclusions: Translation of evidence-based interventions for community health programs requires intervention modification. Community-based culturally relevant cognitive-behavioral interventions can reduce sexual risk behavior among women and men with AIDS lost to follow-up care.