DiFranceisco W, Kelly J A, Otto-Salaj L, McAuliffe T L, Somlai A M, Hackl K, Heckman T G, Holtgrave D R, Rompa D J
Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee 53226-0509, USA.
AIDS Educ Prev. 1999 Feb;11(1):72-86.
Although the efficacy of small-group, risk reduction interventions based on cognitive behavioral principles has been widely documented in HIV behavioral research literature, little is known about how AIDS service organizations (ASOs) view these research-based models. From a nationwide sample of 77 ASOs, this study assessed factors influencing attitudes of prevention program directors and frontline staff toward research-based interventions. Characteristics of individual respondents as well as organizational characteristics of the ASO itself were used to predict perceived benefits of adopting this type of intervention, perceived efficacy (confidence) in the ASO's ability to implement it, and perceived barriers to adoption. Findings revealed uniformly positive perceptions of benefits among respondents from ASOs of different sizes and organizational experiences, although directors held more favorable evaluations than frontline staff. Respondents from ASOs that were larger, had previously delivered group or workshop interventions, or had received outside technical assistance in the past expressed more confidence in the ability of their ASO to implement the intervention. On the other hand, older and more highly education individuals had less confidence in their organization's ability to implement the model. Resource constraints (money, staff, and time) were the most common barriers cited by the respondents. Overall, higher organizational role and longer tenure at an ASO were associated with the perception of more barriers to adopting science-based interventions. Respondents from ASOs with a history of receiving technical assistance reported fewer perceived barriers. The successful dissemination of HIV prevention models from the research arena to the service arena will require mechanisms to provide appropriate funding and technical assistance, particularly to smaller organizations. Mindful of the resource constraints faced by ASOs, researchers can facilitate this process by attempting to develop interventions that are less resource- and time-consuming than current models.
尽管基于认知行为原则的小组风险降低干预措施的效果在艾滋病行为研究文献中已有广泛记载，但对于艾滋病服务组织（ASO）如何看待这些基于研究的模式却知之甚少。本研究从全国77个ASO的样本中，评估了影响预防项目主管和一线工作人员对基于研究的干预措施态度的因素。利用个体受访者的特征以及ASO本身的组织特征来预测采用这类干预措施的感知益处、对ASO实施该措施能力的感知效果（信心）以及采用的感知障碍。研究结果显示，不同规模和组织经验的ASO受访者对益处的看法一致积极，不过主管的评价比一线工作人员更积极。来自规模较大、此前提供过小组或工作坊干预措施或过去接受过外部技术援助的ASO的受访者，对其ASO实施干预措施的能力更有信心。另一方面，年龄较大且受教育程度较高的个体对其组织实施该模式的能力信心较低。资源限制（资金、人员和时间）是受访者提及的最常见障碍。总体而言，在ASO中担任更高的组织角色以及任期更长与认为采用基于科学的干预措施存在更多障碍相关。有接受技术援助历史的ASO的受访者报告的感知障碍较少。将艾滋病预防模式从研究领域成功推广到服务领域需要提供适当资金和技术援助的机制，特别是针对较小的组织。考虑到ASO面临的资源限制，研究人员可以通过尝试开发比当前模式更节省资源和时间的干预措施来推动这一进程。
