دورية أكاديمية
أعرض في EDS

A hybrid design testing a 3-step implementation model for community scale-up of an HIV prevention intervention in rural Malawi: study protocol.

التفاصيل البيبلوغرافية
العنوان: A hybrid design testing a 3-step implementation model for community scale-up of an HIV prevention intervention in rural Malawi: study protocol.
المؤلفون: Jere DLN; Community and Mental Health Nursing, Kamuzu College of Nursing, University of Malawi, P.O Box, 415, Blantyre, Malawi. dijere@kcn.unima.mw., Banda CK; Medical-Surgical Nursing, Kamuzu College of Nursing, University of Malawi, P.O Box, 415, Blantyre, Malawi., Kumbani LC; Faculty of Midwifery, Neonatal and Reproductive Health, Kamuzu College of Nursing, University of Malawi, P.O Box, 415, Blantyre, Malawi., Liu L; Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, USA., McCreary LL; Health Systems Science, College of Nursing, University of Illinois at Chicago, 845 South Damen Ave, Chicago, IL, 60612, USA., Park CG; Health Systems Science, College of Nursing, University of Illinois at Chicago, 845 South Damen Ave, Chicago, IL, 60612, USA., Patil CL; Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, 845 South Damen Ave, Chicago, IL, 60612, USA., Norr KF; Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, 845 South Damen Ave, Chicago, IL, 60612, USA.
المصدر: BMC public health [BMC Public Health] 2018 Aug 02; Vol. 18 (1), pp. 950. Date of Electronic Publication: 2018 Aug 02.
نوع المنشور: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Rural Population*, HIV Infections/*prevention & control , Health Education/*organization & administration , Safe Sex/*statistics & numerical data, Acquired Immunodeficiency Syndrome/prevention & control ; Adolescent ; Adult ; Community Health Workers/education ; Female ; Humans ; Inservice Training/organization & administration ; Malawi/epidemiology ; Male ; Peer Group ; Program Development ; Program Evaluation ; Reproducibility of Results ; Research Design ; Social Behavior ; Young Adult
مستخلص: Background: Scaling-up evidence-based behavior change interventions can make a major contribution to meeting the UNAIDS goal of no new HIV infections by 2030. We developed an evidence-based peer group intervention for HIV prevention and testing in Malawi that is ready for wider dissemination. Our innovative approach turns over ownership of implementation to rural communities. We adapted a 3-Step Implementation Model (prepare, roll-out and sustain) for communities to use. Using a hybrid design, we simultaneously evaluate community implementation processes and program effectiveness.
Methods: Three communities in southern Malawi begin implementation in randomly-assigned order using a stepped wedge design. Our evaluation sample size of 144 adults and 144 youth per community provides sufficient power to examine primary outcomes of condom use and HIV testing. Prior to any implementation, the first participants in all three communities are recruited and complete the Wave 1 baseline survey. Waves 2-4 surveys occur after each community completes roll-out. Each community follows the model's three steps. During Prepare, the community develops a plan and trains peer group leaders. During Roll-Out, peer leaders offer the program. During Sustain, the community makes and carries out plans to continue and expand the program and ultimately obtain local funding. We evaluate degree of implementation success (Aim 1) using the community's benchmark scores (e.g, # of peer groups held). We assess implementation process and factors related to success (Aim 2) using repeated interviews and observations, benchmarks from Aim 1 and fidelity assessments. We assess effectiveness of the peer group intervention when delivered by communities (Aim 3) using multi-level regression models to analyze data from repeated surveys. Finally, we use mixed methods analyses of all data to assess feasibility, acceptability and sustainability (Aim 4).
Discussion: The project is underway, and thus far the first communities have enthusiastically begun implementation. We have had to make several modifications along the way, such as moving from rapid-tests of STIs to symptoms screening by a nurse due to problems with test reliability and availability. If successful, results will provide a replicable evidence-based model for future community implementation of this and other health interventions.
Trial Registration: Clinical Trials.gov NCT02765659 Registered May 6, 2016.
References: Health Educ Res. 2010 Dec;25(6):965-78. (PMID: 20837655)
J Clin Epidemiol. 2013 Dec;66(12):1427-8. (PMID: 24035495)
J Clin Epidemiol. 2013 Jul;66(7):752-8. (PMID: 23523551)
AIDS. 2008 Jun 19;22(10):1177-94. (PMID: 18525264)
AIDS. 2017 Jul 01;31 Suppl 3:S195-S201. (PMID: 28665877)
AIDS Behav. 2013 Feb;17(2):790-800. (PMID: 23054034)
Int J Prev Med. 2012 Jun;3(6):386-93. (PMID: 22783464)
Soc Sci Med. 2015 May;133:136-44. (PMID: 25864150)
J HIV AIDS Soc Serv. 2014;13(3):271-291. (PMID: 25177212)
BMC Health Serv Res. 2011 Sep 30;11:243. (PMID: 21958353)
AIDS Educ Prev. 2009 Jun;21(3):181-206. (PMID: 19519235)
Am J Community Psychol. 2008 Sep;42(1-2):51-9. (PMID: 18612809)
Health Educ Behav. 2011 Apr;38(2):159-70. (PMID: 21393624)
Stat Methods Med Res. 2013 Jun;22(3):324-45. (PMID: 22491174)
Am Psychol. 1989 Sep;44(9):1175-84. (PMID: 2782727)
Qual Health Res. 2003 Jul;13(6):871-83. (PMID: 12891720)
AIDS Behav. 2008 Jul;12(4):521-43. (PMID: 17265011)
Am J Public Health. 2010 Apr 1;100 Suppl 1:S40-6. (PMID: 20147663)
Am J Prev Med. 2012 Sep;43(3):337-50. (PMID: 22898128)
J Adv Nurs. 2012 Aug;68(8):1692-706. (PMID: 22420685)
J Clin Microbiol. 2015 Apr;53(4):1348-50. (PMID: 25609726)
Psychol Bull. 2005 Nov;131(6):856-97. (PMID: 16351327)
J Clin Epidemiol. 2011 Sep;64(9):936-48. (PMID: 21411284)
Stat Med. 2015 Jan 30;34(2):181-96. (PMID: 25346484)
Med Care. 2012 Mar;50(3):217-26. (PMID: 22310560)
J Adv Nurs. 2018 May;74(5):1051-1058. (PMID: 29098709)
AIDS. 2010 Jan 2;24(1):85-91. (PMID: 19809271)
Ann Indian Acad Neurol. 2008 Jan;11(1):28-32. (PMID: 19966975)
Acta Paediatr. 2005 Jul;94(7):924-7. (PMID: 16188816)
Geriatr Gerontol Int. 2010 Jul;10(3):225-32. (PMID: 20141536)
Acta Paediatr. 2005 Aug;94(8):1102-8. (PMID: 16188856)
Implement Sci. 2014 Jun 20;9:79. (PMID: 24950708)
AIDS Behav. 2008 May;12(3):335-53. (PMID: 17896176)
J Sex Transm Dis. 2016;2016:8695146. (PMID: 27195171)
Acta Paediatr. 2003 Jun;92(6):709-14. (PMID: 12856983)
Am J Epidemiol. 1996 Aug 15;144(4):425-33. (PMID: 8712201)
Infect Dis Clin North Am. 2009 Jun;23(2):309-14. (PMID: 19393911)
Disasters. 2006 Jun;30(2):199-211. (PMID: 16689918)
معلومات مُعتمدة: R01 NR015409 United States NR NINR NIH HHS
فهرسة مساهمة: Keywords: Adolescent; Adult; Community implementation; Community participation; HIV prevention; Implementation science; Malawi; Peer group intervention
سلسلة جزيئية: ClinicalTrials.gov NCT02765659
تواريخ الأحداث: Date Created: 20180804 Date Completed: 20190916 Latest Revision: 20240329
رمز التحديث: 20240329
مُعرف محوري في PubMed: PMC6090759
DOI: 10.1186/s12889-018-5800-3
PMID: 30071866
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2458
DOI:10.1186/s12889-018-5800-3