Beadnell B, Baker S, Knox K, Stielstra S, Morrison D M, Degooyer E, Wickizer L, Doyle A, Oxford M
School of Social Work, University of Washington, Seattle 98105, USA.
AIDS Care. 2003 Dec;15(6):807-20. doi: 10.1080/09540120310001618658.
We examined attrition from an HIV/STD group counselling intervention in two ways: quantitative analyses of the entire sample (n=287) and structured interviews of a subset of 30 women with low attendance. In the interviews, the most common reasons for low attendance were time conflicts and enrolling primarily to obtain the monetary incentives given for completing research questionnaires. Latent class statistical analysis of the full sample identified two subgroups that differed from each other in the number of psychosocial problems recently experienced. Relative to the 'non-distressed' class, the 'distressed' class members had higher probabilities of psychological distress, low incomes, heavy substance use, sex for trade, relationship violence, and unstable housing. This group had higher HIV/STD risk, but lower intervention attendance. Members also had less education and less knowledge about HIV/STD. A higher proportion of the distressed group was African-American. Study findings suggest that in interventions for women at HIV/STD risk, it is not necessarily enough to ensure cultural relevance and to provide food, childcare, and transportation. To increase retention, interventionists should consider (1) the use of strategies to support attendance (such as monetary incentives and attention to group process factors) and (2) intervention formats that are brief, matched to participants' stage of change, population-specific, and/or maximally accessible.
我们从两个方面对一项针对艾滋病毒/性传播感染群体的咨询干预措施中的人员流失情况进行了研究:对整个样本(n = 287)进行定量分析,以及对30名出勤率低的女性进行结构化访谈。在访谈中,出勤率低的最常见原因是时间冲突,以及主要为了获得完成研究问卷所给予的金钱奖励而参与进来。对整个样本进行的潜在类别统计分析确定了两个亚组,这两个亚组在近期经历的心理社会问题数量上存在差异。相对于“非苦恼”类别,“苦恼”类别成员出现心理困扰、低收入、大量使用毒品、性交易、关系暴力和住房不稳定的可能性更高。该组艾滋病毒/性传播感染风险更高,但干预措施的出勤率更低。成员的受教育程度和对艾滋病毒/性传播感染的了解也更少。苦恼组中非洲裔美国人的比例更高。研究结果表明,在针对有艾滋病毒/性传播感染风险的女性的干预措施中,仅仅确保文化相关性并提供食物、儿童保育和交通可能并不够。为了提高留存率,干预者应考虑:(1)采用支持出勤的策略(如金钱奖励和关注群体过程因素);(2)采用简短、与参与者的改变阶段相匹配、针对特定人群和/或最大限度便于参与的干预形式。