Sanders Mechelle, Tobin Jonathan N, Cassells Andrea, Carroll Jennifer, Holder Tameir, Thomas Marie, Fiscella Kevin
University of Rochester Medical Center, 1381 South Ave., Rochester, NY 14620, USA.
Clinical Directors Network, Inc. (CDN), 5 West 37 St., 10 Floor, New York, NY, USA.
PEC Innov. 2023 Feb 18;2:100139. doi: 10.1016/j.pecinn.2023.100139. eCollection 2023 Dec.
To examine longitudinal changes in activation, HIV health outcomes, and social and psychological determinants of adherence to antiretroviral therapy (ART) among peer trainers with HIV.
A multi-method case study. The study population included peers ( = 4) from a randomized controlled trial about peers training patients with HIV ( = 359) to better manage their health. Each peer completed a semi-structured interview that we analyzed using Social Learning Theory (SLT) as a guiding framework. The peers also completed longitudinal surveys about their health after each training cohort ( = 5) over 3-years.
Peers reported personal benefits from training others with HIV in self-management. Their self-reported activation, self-efficacy and some health outcomes increased overtime. The peers mentioned SLT principles during their interviews. Generally, the peers enjoyed and benefited from training others with HIV in a group-based learning environment.
Our findings suggest peer leadership can serve as a means for empowerment that is effective at both supporting improvements in health outcomes for patients and for themselves, which may be both scalable and sustainable.
To our knowledge, this is the first mixed-methods study to show reciprocal long-term improvement in health behaviors in a diverse group of peers training others with HIV to self-manage their care.
研究感染艾滋病毒的同伴培训者在抗逆转录病毒治疗（ART）依从性方面的激活状态、艾滋病毒健康结果以及社会和心理决定因素的纵向变化。
一项多方法案例研究。研究人群包括来自一项随机对照试验的同伴（n = 4），该试验是关于同伴培训艾滋病毒患者（n = 359）以更好地管理自身健康。每位同伴完成了一次半结构化访谈，我们以社会学习理论（SLT）为指导框架对其进行分析。同伴们还在3年时间里，在每个培训队列（n = 5）结束后完成了关于自身健康的纵向调查。
同伴们报告称，在自我管理方面培训其他艾滋病毒感染者让他们个人受益。他们自我报告的激活状态、自我效能感和一些健康结果随时间有所增加。同伴们在访谈中提到了社会学习理论的原则。总体而言，同伴们在基于小组的学习环境中培训其他艾滋病毒感染者时感到愉快并从中受益。
我们的研究结果表明，同伴领导可以作为一种赋权手段，在支持改善患者和他们自己的健康结果方面都是有效的，这可能具有可扩展性和可持续性。
据我们所知，这是第一项混合方法研究，表明在一个多样化的同伴群体中，培训其他艾滋病毒感染者进行自我护理时，健康行为会出现相互的长期改善。
