Dolcini M Margaret, Catania Joseph A, Gandelman Alice, Ozer Elizabeth M
Hallie E. Ford Center for Healthy Children and Families, School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, 2631 SW Campus Way, Corvallis, OR 97331 USA.
California STD/HIV Prevention Training Center, University of California, San Francisco, CA USA.
Transl Behav Med. 2014 Dec;4(4):424-33. doi: 10.1007/s13142-014-0268-x.
Dissemination of HIV behavioral prevention programs has increased the reach of evidence-based interventions, but there is a paucity of data on implementation and diffusion. The present mixed methods study focused on RESPECT, a brief counseling and testing intervention, examining compliance fidelity and the extent to which Centers for Disease Control and Prevention (CDC) policies and training have diffused to practice settings. Using client exit surveys (N = 830) and counselor interviews (N = 64), we examined implementation in 26 community-based agencies (CBOs) and public health departments (DPHs) in the USA. Multivariate analyses showed that at-risk clients, ethnic minority clients, and those who were primarily seeking services other than HIV/STI testing, were more likely to receive the program with fidelity. Counselor data suggested that multiple factors (e.g., client characteristics, agency structure) impact program adaptations. RESPECT is being delivered with good fidelity and reaching at-risk clients. The data provide support for CDC diffusion efforts. Future studies should continue to examine compliance fidelity and program sustainability.
艾滋病病毒行为预防项目的推广扩大了循证干预措施的覆盖范围，但关于实施和传播的数据却很匮乏。目前这项混合方法研究聚焦于“尊重”（RESPECT），这是一种简短的咨询和检测干预措施，旨在考察依从性保真度以及疾病控制与预防中心（CDC）的政策和培训在实践环境中的传播程度。通过客户离场调查（N = 830）和咨询师访谈（N = 64），我们考察了美国26个社区机构（CBO）和公共卫生部门（DPH）的实施情况。多变量分析表明，高危客户、少数族裔客户以及那些主要寻求艾滋病病毒/性传播感染检测以外服务的客户，更有可能接受保真度高的项目。咨询师数据表明，多种因素（如客户特征、机构结构）会影响项目调整。“尊重”项目的实施保真度良好，且覆盖了高危客户。这些数据为疾病控制与预防中心的传播工作提供了支持。未来的研究应继续考察依从性保真度和项目可持续性。
