VA HSR&D Houston Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, Texas, USA.
AIDS Patient Care STDS. 2012 Mar;26(3):165-72. doi: 10.1089/apc.2011.0248. Epub 2012 Jan 16.
Although peer interventionists have been successful in medication treatment-adherence interventions, their role in complex behavior-change approaches to promote entry and reentry into HIV care requires further investigation. The current study sought to describe and test the feasibility of a standardized peer-mentor training program used for MAPPS (Mentor Approach for Promoting Patient Self-Care), a study designed to increase engagement and attendance at HIV outpatient visits among high-risk HIV inpatients using HIV-positive peer interventionists to deliver a comprehensive behavioral change intervention. Development of MAPPS and its corresponding training program included collaborations with mentors from a standing outpatient mentor program. The final training program included (1) a half-day workshop; (2) practice role-plays; and (3) formal, standardized patient role-plays, using trained actors with "real-time" video observation (and ratings from trainers). Mentor training occurred over a 6-week period and required demonstration of adherence and skill, as rated by MAPPS trainers. Although time intensive, ultimate certification of mentors suggested the program was both feasible and effective. Survey data indicated mentors thought highly of the training program, while objective rating data from trainers indicated mentors were able to understand and display standards associated with intervention fidelity. Data from the MAPPS training program provide preliminary evidence that peer mentors can be trained to levels necessary to ensure intervention fidelity, even within moderately complex behavioral-change interventions. Although additional research is needed due to limitations of the current study (e.g., limited generalizability due to sample size and limited breadth of clinical training opportunities), data from the current trial suggest that training programs such as MAPPS appear both feasible and effective.
尽管同伴干预者在药物治疗依从性干预方面取得了成功，但他们在促进进入和重新进入 HIV 护理的复杂行为改变方法中的作用仍需要进一步研究。本研究旨在描述和测试一种标准化的同伴导师培训计划在 MAPPS（促进患者自我护理的导师方法）中的可行性，该研究旨在通过使用 HIV 阳性同伴干预者为高风险 HIV 住院患者提供综合行为改变干预措施，增加他们参与和出席 HIV 门诊就诊的机会。MAPPS 的开发及其相应的培训计划包括与门诊导师计划中的导师合作。最终的培训计划包括：（1）半天的研讨会；（2）实践角色扮演；（3）使用经过培训的演员进行正式、标准化的患者角色扮演，并进行“实时”视频观察（以及培训师的评分）。导师培训持续了 6 周，需要按照 MAPPS 培训师的评估，展示出对培训计划的坚持和技能。尽管时间紧张，但导师的最终认证表明该计划是可行且有效的。调查数据表明，导师对培训计划评价很高，而来自培训师的客观评分数据表明，导师能够理解并展示与干预保真度相关的标准。MAPPS 培训计划的数据提供了初步证据，表明可以培训同伴导师，使其达到确保干预保真度所需的水平，即使在中等复杂的行为改变干预中也是如此。尽管由于当前研究的限制（例如，由于样本量有限和临床培训机会有限，推广性有限）需要进一步研究，但当前试验的数据表明，MAPPS 等培训计划似乎既可行又有效。
