Wainberg Milton L, McKinnon Karen, Mattos Paulo E, Pinto Diana, Mann Claudio Gruber, de Oliveira Claudia Simone Dos Santos, de Oliveira Suely Broxado, Remien Robert H, Elkington Katherine S, Cournos Francine
HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, Unit 112, New York, NY 10032, USA.
AIDS Behav. 2007 Nov;11(6):872-83. doi: 10.1007/s10461-006-9181-8. Epub 2007 Jan 10.
As in other countries worldwide, adults with severe mental illness in Brazil have elevated rates of HIV infection relative to the general population. However, no HIV prevention interventions have been tested for efficacy with psychiatric patients in Brazil. We conducted participatory research with local providers, community leaders, patient advocates, and patients using an intervention adaptation process designed to balance fidelity to efficacious interventions developed elsewhere with fit to a new context and culture. Our process for adapting these interventions comprised four steps: (1) optimizing fidelity; (2) optimizing fit; (3) balancing fidelity and fit; and (4) pilot testing and refining the intervention. This paper describes how these steps were carried out to produce a Brazilian HIV prevention intervention for people with severe mental illness. Our process may serve as a model for adapting existing efficacious interventions to new groups and cultures, whether at a local, national, or international level.
与世界其他国家一样，巴西患有严重精神疾病的成年人感染艾滋病毒的比例相对于普通人群有所升高。然而，巴西尚未对针对精神病患者的艾滋病毒预防干预措施进行有效性测试。我们与当地提供者、社区领袖、患者权益倡导者以及患者开展了参与式研究，采用了一种干预适应过程，旨在平衡对其他地方开发的有效干预措施的忠实度与对新环境和文化的适应性。我们对这些干预措施进行适应的过程包括四个步骤：（1）优化忠实度；（2）优化适应性；（3）平衡忠实度和适应性；（4）对干预措施进行试点测试和完善。本文描述了如何执行这些步骤以制定针对严重精神疾病患者的巴西艾滋病毒预防干预措施。我们的过程可作为将现有有效干预措施适用于新群体和新文化的模型，无论是在地方、国家还是国际层面。
