Controlled outcome studies have convincingly established the efficacy of cognitive-behavioral group interventions for promoting change in HIV risk sexual behaviors. It is possible to characterize these successful intervention models based on their similar conceptual underpinnings, behavior change principles, intensity, and cultural tailoring. Unfortunately, the service programs of community-based AIDS prevention organizations rarely reflect the use of these HIV prevention models shown to be efficacious and, based on our preliminary studies, the prevention services of most CBO's consist almost exclusively of AIDS educational presentations. Efforts to disseminate efficacious HIV prevention models from the research arena to frontline HIV prevention service organizations are urgently needed, but there have been no studies to date evaluating how best to facilitate this HIV prevention """"""""technology transfer."""""""" This application proposes HIV prevention mental health services research to evaluate social learning-based strategies to promote the adoption of cognitive-behavioral group intervention models by AIDS prevention CBO's with two target client populations, gay men and high-risk women. Following baseline assessment of the AIDS prevention service activities of 75 CBO's, the organizations will be randomly assigned to one of three experimental dissemination conditions: (1) a control condition where CBO AIDS prevention service activities will be monitored; (2) a """"""""traditional training workshop"""""""" dissemination model in which CBO prevention personnel will be intensively trained in a single workshop to deliver the cognitive- behavioral HIV prevention intervention model; or (3) an """"""""enhanced dissemination"""""""" condition incorporating both the training workshop and ongoing telephone-based consultation, problem-solving, reinforcement, and booster training of model program implementation strategies for CBO's. Probe check data will be collected from CBO clients served by the intervention model to estimate its field efficacy. The dissemination interventions will be evaluated by following each CBO for eighteen months to identify rates and predictors of program model adoption, number of CBO clients served with the program model, and indices of CBO staff satisfaction, CBO client satisfaction, and cost effectiveness with respect to behavior change expected and new HIV infections averted through the dissemination and adoption of more effective HIV prevention approaches. If successful, this research will provide important new information of strategies to promote the dissemination or transfer of HIV prevention technology from the research arena to service providers who urgently need improved HIV prevention models.
