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首页> 外文期刊>Revista Brasileira de Psiquiatria >Challenges and opportunities in the science of research to practice: lessons learned from a randomized controlled trial of a sexual risk-reduction intervention for psychiatric patients in a public mental health system
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Challenges and opportunities in the science of research to practice: lessons learned from a randomized controlled trial of a sexual risk-reduction intervention for psychiatric patients in a public mental health system

机译：练习研究科学的挑战与机遇：从一项公共心理健康系统中对性风险降低干预的随机对照试验中学到的经验教训

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Objective: Human immunodeficiency virus (HIV) prevention efficacy trials with psychiatric patients have been conducted in research settings in high-resourced countries, establishing short-term efficacy for reducing sexual risk behavior. None has been implemented within systems of care. In the last decade, overcoming this research-to-practice gap has become a focus of implementation science. This paper describes the first and only HIV Prevention intervention trial for psychiatric patients conducted in real-world outpatient psychiatric settings facilitated by trained clinic-based providers. Methods: The HIV Prevention intervention, which uses the Information-Motivation-Behavioral Skills model to achieve sexual risk-reduction, was rigorously adapted to the local context and clinic services’ needs. Participants from eight clinics were randomized to HIV Prevention or Health Promotion conditions. Results: HIV Prevention participants showed significant improvement in Information-Motivation-Behavioral domains; in this group, behavioral intentions were associated with significantly fewer unprotected sex occasions, but reduction of unprotected sex occasions was similar in both conditions. Conclusion: Our trial was conducted before implementation studies became widely funded. Transporting an intervention to a new culture or into real-world practice settings may require adaptations. Our results demonstrate that clear guidelines are needed regarding whether to conduct efficacy, effectiveness, and/or implementation research as the most appropriate next step.
机译：目的：人类免疫缺陷病毒（HIV）预防患者的预防疗效试验在高资源国家的研究环境中进行，建立了减少性风险行为的短期疗效。没有人在护理系统内实施。在过去的十年中，克服了这项研究 - 实践差距已成为实施科学的重点。本文介绍了由训练有素的基于诊所的提供商促进的现实世界门诊精神病环境中进行的精神病患者的第一个和唯一艾滋病毒预防干预试验。方法：利用信息动力行为技能模型实现性风险减少的艾滋病病毒预防干预严格适应当地的情境和诊所服务的需求。八个诊所的参与者随机预防艾滋病毒预防或健康促进条件。结果：艾滋病毒预防参与者在信息动机行为域中表现出显着改善;在这一组中，行为意图与明显少的无保护的性偶，但在这两个条件下，无保护的性别场合的减少相似。结论：我们的审判在实施研究被广泛资助之前进行。运输对新文化或现实世界练习环境的干预可能需要适应。我们的结果表明，关于是否进行疗效，有效性和/或实施研究，所以需要明确的指导方针作为最合适的下一步。

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