Implementation of a couple-based HIV prevention program: a cluster randomized trial comparing manual versus Web-based approaches

Implementation Science

Robert Remien³  Jessica Rowe¹  Ryan Kelsey¹  Mingway Chang²  Katie Potocnik Medina²  Louisa Gilbert²  Timothy Hunt²  Nabila El-Bassel²  Elwin Wu²  Susan S Witte² 

[1] Center for New Media Teaching and Learning (CCNMTL), Columbia University, 535 W. 114th St, Suite 505, New York 10027, NY, USA;Social Intervention Group, Columbia University School of Social Work, 1255 Amsterdam Ave, New York 10027, NY, USA;HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, New York 10032, NY, USA

关键词: Web-based;    Multimedia;    HIV prevention;    Implementation;    Couple-based;   

Others  :  1146459
DOI  :  10.1186/s13012-014-0116-x

 received in 2013-11-22, accepted in 2014-08-23,  发布年份 2014

【 摘 要 】

Background

Despite great need, the number of HIV prevention implementation studies remains limited. The challenge for researchers, in this time of limited HIV services agency resources, is to conceptualize and test how to disseminate efficacious, practical, and sustainable prevention programs more rapidly, and to understand how to do so in the absence of additional agency resources. We tested whether training and technical assistance (TA) in a couple-based HIV prevention program using a Web-based modality would yield greater program adoption of the program compared to training and TA in the same program in a manual-based modality among facilitators who delivered the interventions at 80 agencies in New York State.

Methods

This study used a cluster randomized controlled design. Participants were HIV services agencies (N?=?80) and up to 6 staff members at each agency (N?=?253). Agencies were recruited, matched on key variables, and randomly assigned to two conditions. Staff members participated in a four-day, face-to-face training session, followed by TA calls at two and four months, and follow-up assessments at 6, 12, and 18 months post- training and TA. The primary outcomes examined number of couples with whom staff implemented the program, mean number of sessions implemented, whether staff implemented at least one session or whether staff implemented a complete intervention (all six sessions) of the program. Outcomes were measured at both the agency and participant level.

Results

Over 18 months following training and TA, at least one participant from 13 (33%) Web-based assigned agencies and 19 (48%) traditional agencies reported program use. Longitudinal multilevel analysis found no differences between groups on any outcomes at the agency or participant level with one exception: Web-based agencies implemented the program with 35% fewer couples compared with staff at manual-based agencies (IRR 0.35, CI, 0.13-0.94).

Conclusion

Greater implementation of a Web-based program may require more resources and staff exposure, especially when paired with a couple-based modality. Manual-based and traditional programs may hold some advantage or ease for implementation, particularly at a time of low economic resources.

Trial registration

ClinicalTrials.gov identifier: NCT01863537 webcite

【 授权许可】

   
2014 Witte et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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