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首页> 外文期刊>AIDS patient care and STDs >Positive Strategies to Enhance Problem-Solving Skills (STEPS): A Pilot Randomized, Controlled Trial of a Multicomponent, Technology-Enhanced, Customizable Antiretroviral Adherence Intervention for HIV-Infected Adolescents and Young Adults
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Positive Strategies to Enhance Problem-Solving Skills (STEPS): A Pilot Randomized, Controlled Trial of a Multicomponent, Technology-Enhanced, Customizable Antiretroviral Adherence Intervention for HIV-Infected Adolescents and Young Adults

机译：提高问题解决技巧的积极策略（步骤）：试点随机，对受控试验的多组分，技术增强，可定制的抗逆转录病毒依从性干预艾滋病毒感染的青少年和年轻人

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Adolescents are disproportionately impacted by HIV in the United States. Optimal effects from antiretroviral therapy (ART) can be achieved through stringent adherence to a daily medication regimen; for adolescents, this may be interrupted due to complex barriers unique to this age group. We previously conducted formative qualitative interviews with HIV-infected adolescents to identify key barriers facing adolescents regarding ART adherence and potential strategies to address these barriers. These data were used to inform an ART adherence intervention designed to overcome difficulties unique to HIV-infected adolescents (e.g., internalized stigma and HIV-related shame, disclosure to sexual partners, social life, and extracurricular activities at school, etc.). The resulting intervention—“Positive Strategies To Enhance Problem-solving Skills (Positive STEPS)”—combines five individual counseling sessions with daily text message reminders. We conducted a pilot randomized controlled trial of the intervention against a standard of care control and report on the feasibility of procedures and participant acceptability of the intervention in terms of content, structure, and format. ART adherence was measured in both arms through Medication Event Monitoring System pill caps and self-report. Feasibility and acceptability of the Positive STEPS intervention was evidenced by 90% retention for the intervention sessions; 100% completion of the four-month assessment; and positive responses on postintervention evaluation forms (all intervention participants rated Positive STEPS as “acceptable” or “very acceptable”) and brief exit interviews. At the 4-month assessment visit, the change in ART adherence among the intervention group [mean change score = 13%, standard deviation (SD) = 29.5] was significantly higher compared with the standard of care group (mean change score = ?26%, SD = 26.0; Cohen's d effect size = 1.43, confidence interval = 0.17–2.49, p = 0.02). Future testing of the intervention in a fully powered randomized controlled trial to determine efficacy is warranted.
机译：青少年对美国艾滋病毒影响不成比例地影响。通过严格依从每日药物治疗方案，可以实现抗逆转录病毒治疗（ART）的最佳效果;对于青少年来说，由于这个年龄组的复杂障碍，这可能被打断。我们以前进行了与艾滋病毒感染的青少年的形成性定性访谈，以确定面对青少年关于艺术遵守和解决这些障碍的潜在策略的关键障碍。这些数据用于通知旨在克服艾滋病毒感染青少年（例如，内化耻辱和艾滋病毒和艾滋病毒相关耻辱，披露学校的性伴侣，社会生活和课外活动的难以克服独特的粘附干预措施。由此产生的干预 - “提高问题解决技能的积极策略（积极步骤） - 将五个单独的咨询课程与日常短信提醒结合起来。我们进行了针对护理标准的干预的试点随机对照试验，并报告了程序的程序和参与者在内容，结构和格式方面的可接受性和参与者的可接受性。通过药物事件监测系统丸帽和自我报告，在双臂中测量艺术粘附。积极步骤干预的可行性和可接受性得到了治疗干预会议的90％; 100％完成四个月的评估;在临床临时评估表格中的积极响应（所有干预参与者评定为“可接受的”或“非常可接受”）和“非常可接受”的积极措施。在4个月的评估访问中，与护理标准相比，干预组之间的艺术遵守变更[平均变化得分= 13％，标准差（SD）= 29.5]显着提高（平均变化得分=？26 ％，SD = 26.0; COHEN的D效应大小= 1.43，置信区间= 0.17-2.49，P = 0.02）。未来的介入在完全供电的随机对照试验中进行干预以确定有效性。

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