Suchergebnisse

Purpose: Rigorous adaptation methods are needed to revise existing evidence-based behavioral interventions for implementation for new target populations, revised/updated outcomes, new delivery modalities, recent advances, and new technologies. We describe an adaptation method designed to overcome the real-world challenges of having very limited existing expertise, resources, and time. Method: This adaptation method and accompanying visualization tool ("Deconstruction/Reconstruction Matrix") preserves theoretical mechanisms of behavior change, accounts for challenges in utilizing new technologies, and strengthens clinical processes, with an emphasis on safety. Results: The adaptation of an in-person HIV behavioral intervention for sexual and gender diverse men in Kazakhstan to one delivered remotely via telecommunication and social media technologies exemplifies the process and strengths of the method, concomitantly resulting in recommendations for adaptation and implementation of mobile health (mHealth) and digital health interventions. Discussion: This method allows researchers and clinicians to adapt interventions rapidly and rigorously and to benefit from new technologies.

Intimate partner violence (IPV), HIV, and substance use are serious intersecting public health issues. This paper aims to describe the Social Intervention Group (SIG)'s syndemic-focused interventions for women that address the co-occurrence of IPV, HIV, and substance use, referred to as the SAVA syndemic. We reviewed SIG intervention studies from 2000 to 2020 that evaluated the effectiveness of syndemic-focused interventions which addressed two or more outcomes related to reducing IPV, HIV, and substance use among different populations of women who use drugs. This review identified five interventions that co-targeted SAVA outcomes. Of the five interventions, four showed a significant reduction in risks for two or more outcomes related to IPV, substance use, and HIV. The significant effects of SIG's interventions on IPV, substance use, and HIV outcomes among different populations of women demonstrate the potential of using syndemic theory and methods in guiding effective SAVA-focused interventions.

Objectives: This article describes the process used to adapt the only group-based, computer-assisted, HIV/sexually transmitted infections (STI) prevention intervention designed for drug-using Black women in community corrections using an integrated health equity ADAPT-ITT framework with a peer engagement lens. Methods: Key adaptation partners included cisgender, drug-using Black women in community corrections, and Black, female, community reentry providers slated to deliver the adapted intervention. Focus groups and a study pilot were held. Results: The resulting intervention, Empowering African-American Women on the Road to Health (E-WORTH), features HIV/STI-specific Afrocentric themes of risk and resiliency tailored for and by Black women in the criminal legal system. Evaluation of E-WORTH confirms its cultural resonance. Participants had a 54% lowered odds of testing positive for any STI and reported 38% fewer acts of condomless vaginal or anal intercourse at 12-month follow-up. Conclusions: Findings underscore the need to develop an adaptation model that is explicitly health equity in focus.

Treatment as usual has historically been used as control arms for randomized controlled trials (RCTs), but utilizing wellness interventions as active comparison conditions can advance the evidence base of such interventions while increasing access to health promotion content. We use the results from the CONNECT 2 RCT's wellness intervention control arm as a case example of active comparison conditions that can control for dosage or attentional effects in future research. We summarized existing studies on wellness control HIV RCT interventions, introduced CONNECT 2, and discussed recruitment, randomization, and the intervention. Overall, Wellness Promotion participants were more likely to engage in physical activity, eat healthier, and do more vigorous exercise when compared with HIV Risk Reduction. CONNECT 2 Wellness intervention results solidify why wellness interventions can play an important role in treatment guidelines. Developing and implementing this model can be a more ethical, equitable, and holistic approach among underserved communities.

Purpose: We aimed to help community stakeholders develop a shared understanding of the opioid crisis through qualitative system dynamics (SD) modeling to inform local strategies for prevention and treatment. Methods: As part of the HEALing Communities Study-New York State, we used secondary qualitative data from community stakeholder interviews and coalition meeting notes to develop qualitative SD models that elucidate the interdependencies and feedback structures underlying the opioid epidemic in each community. Results: The synthesized model revealed multiple balancing and reinforcing feedback loops that influenced the adoption and reach of evidence-based practices to reduce opioid overdose and fatality. Conclusion: SD modeling is a novel approach to helping community stakeholders to see the inter-connectedness of actors, factors and sectors and the need for multiple mutually reinforcing strategies to avert opioid overdose and fatality. Social workers could play a key role in linking actions across sectors in such a complex system.

Purpose: This paper reports a review of couple-based behavioral HIV interventions conducted by the Social Intervention Group (SIG); and addresses gaps, future directions, and implications for couple-based HIV interventions. Method: We performed a literature review for SIG research on intervention and prevention studies involving couples/partners. Results: We identified nine couple-based interventions. Outcomes included reduced sexual and substance use-related risk behaviors and improved use of anti-retroviral treatment. We conducted these studies in diverse venues, including needle/syringe exchange programs, primary care clinics, and criminal justice settings. Conclusions: The findings of this review provide strong evidence for the efficacy of couple-based HIV interventions in reducing sexual HIV risks and linkage to HIV and substance-use treatment. SIG has advanced couple-based HIV intervention research science by improving study design, intervention core components, conceptual models, and implementation strategies; which have informed scientific directions and transformed couple-based HIV prevention research.