Copenhaver Michael, Chowdhury Sutopa, Altice Frederick L
Allied Health Sciences, University of Connecticut, Storrs, Connecticut 06269, USA.
AIDS Patient Care STDS. 2009 Apr;23(4):277-87. doi: 10.1089/apc.2008.0157.
No evidence-based interventions (EBIs) have been designed for implementation during the critical period when HIV-infected prisoners are being transitioned from prison to the community. We therefore conducted formative research aimed at systematically selecting and adapting an EBI that integrates HIV risk reduction and adherence to antiretroviral therapy to implement among HIV-infected prisoners transitioning back to the community. Our formative research involved a critical examination of established EBIs and associated published reports complemented by data elicited through structured interviews with key stakeholders in community and correctional settings and members of the target population. Between September 2006 and February 2007, structured one-on-one interviews were conducted with key stakeholders in the target organizations (n = 19) and with members of the target population (n = 26) in Hartford and New Haven, Connecticut. Based on the formative research, we abbreviated and adapted the Holistic Health Recovery Program targeting people living with HIV (HHRP+), an EBI, to consist of four 45-minute sessions that cover a range of prespecified topics so that participants may individually apply intervention content as needed to their own HIV risk profile and antiretroviral adherence issues. The EBI was adapted so that it could be provided in an individual or group format and delivered in either consecutive or weekly sessions and so that it could be provided within the prison system and delivered just prior to release, or in a community-based setting where it could be delivered immediately after release. This study provides a comprehensive exemplar of the process of selecting and adapting an EBI taking into account both empirical evidence and input from target organization stakeholders and target population members in real-world settings where high-risk populations are concentrated.
目前尚未设计出基于证据的干预措施（EBI），以便在感染艾滋病毒的囚犯从监狱过渡到社区的关键时期实施。因此，我们开展了形成性研究，旨在系统地选择和调整一种将降低艾滋病毒风险与坚持抗逆转录病毒治疗相结合的EBI，以便在回归社区的感染艾滋病毒的囚犯中实施。我们的形成性研究包括对既定的EBI及相关已发表报告进行批判性审查，并辅以通过对社区和惩教机构的关键利益相关者以及目标人群成员进行结构化访谈得出的数据。2006年9月至2007年2月期间，在康涅狄格州哈特福德和纽黑文，对目标组织的关键利益相关者（n = 19）和目标人群成员（n = 26）进行了结构化一对一访谈。基于形成性研究，我们对针对艾滋病毒感染者的整体健康恢复计划（HHRP+）这一EBI进行了简化和调整，使其由四个45分钟的环节组成，并涵盖一系列预先确定的主题，以便参与者能够根据自身的艾滋病毒风险状况和抗逆转录病毒治疗依从性问题，按需单独应用干预内容。对该EBI进行了调整，使其既可以以个人或小组形式提供，也可以连续或每周进行授课，并且既可以在监狱系统内提供并在释放前进行授课，也可以在社区环境中提供并在释放后立即进行授课。本研究提供了一个全面的范例，展示了在高风险人群集中的现实环境中，如何兼顾实证证据以及目标组织利益相关者和目标人群成员的意见，来选择和调整EBI的过程。
