Semel Institute for Neuroscience and Human Behavior.
Department of Psychology.
J Consult Clin Psychol. 2021 Feb;89(2):81-95. doi: 10.1037/ccp0000622.
The Teaching, Raising, And Communicating with Kids (TRACK) study was a full-scale longitudinal efficacy trial of a previously successful pilot intervention, which aims to assist mothers living with HIV (MLH) with serostatus disclosure to their children. The study looked to test the key components of the theoretical model with a more diverse sample than that of the pilot.
MLH (mean age = 39.27, SD 7.89) and their children (6-14 years) were recruited in Southern California and Atlanta and randomized to an intervention or wait-list control group (N = 176 dyads). TRACK used behavioral exercises within three individual sessions, with assessments at baseline, 3-, 9-, and 15-month follow-ups regarding HIV disclosure, targeted intermediate variables (communication, parental coping, family routines, and disclosure self-efficacy), and outcome variables for MLH's health and mental health, children's mental health, and family relationships/functioning.
TRACK MLH were four times more likely to disclose their HIV serostatus than controls, with the rate increasing to six times more likely applying generalized estimating equation (GEE) logistic regression. Intervention MLH showed improvements in communication, social support, family routines, and most significantly, disclosure self-efficacy. Intervention MLH demonstrated decreased anxiety and better mental health scores; their children reported significantly more decline in worry than controls. This full-scale trial, over and above the pilot, showed the intervention improved outcomes across multiple sites, and found all targeted intermediate variables improved in the intervention group relative to the control group.
TRACK helped mothers to disclose their status to their children and improved mental health outcomes, especially anxiety. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
“与孩子教学、养育和沟通（TRACK）”研究是一项对先前成功试点干预措施的全面纵向疗效试验，旨在帮助携带艾滋病毒的母亲（MLH）向其子女透露其艾滋病毒感染状况。该研究旨在用比试点研究更具多样性的样本测试理论模型的关键组成部分。
在南加州和亚特兰大招募 MLH（平均年龄=39.27，SD=7.89）及其子女（6-14 岁），并将他们随机分配到干预组或等待名单对照组（N=176 对母子）。TRACK 在三次单独的会议中使用行为练习，在基线、3、9 和 15 个月的随访中评估 HIV 披露、针对中间变量（沟通、父母应对、家庭常规和披露自我效能）以及 MLH 的健康和心理健康、儿童心理健康和家庭关系/功能的结果变量。
TRACK 的 MLH 披露其 HIV 感染状况的可能性是对照组的四倍，应用广义估计方程（GEE）逻辑回归的可能性增加到六倍。干预组 MLH 在沟通、社会支持、家庭常规方面有改善，最显著的是披露自我效能方面有改善。干预组 MLH 表现出焦虑减轻和心理健康得分提高；他们的孩子报告的担忧明显比对照组少。这项全面的试验，超过了试点研究，表明该干预措施在多个地点改善了结果，并发现干预组相对于对照组，所有针对的中间变量都有所改善。
TRACK 帮助母亲向子女透露其状况，并改善了心理健康结果，特别是焦虑。
