Great advances have been made in our scientific knowledge about effective HIV prevention interventions. However, this research can help to curtail an epidemic that remains out-of-control in most of the world only when evidence-based HIV prevention interventions are moved from the research arena into the hands of frontline service providers and can be successfully used by them. New, sustainable approaches are needed to quickly, flexibly, and cost-effectively disseminate advances in HIV prevention science-whenever they occur-to providers who deliver prevention services. Advanced interactive communication technologies can potentially be used to disseminate new evidence-based interventions to service providers on a global level, but the effects of distance training programs have not been compared to more traditional provider training methods. This study will enroll a sample of 99 AIDS nongovernmental organizations (NGOs) from countries in Eastern Europe, a region with HIV incidence among the highest in the world. The study will disseminate a community-level HIV prevention intervention-the """"""""Popular Opinion Leader"""""""" (POL) model-shown efficacious in the research literature, adaptable cross-culturally, and widely requested by NGOs in the region. In-depth baseline telephone interview assessments with NGO directors and frontline staff will measure current prevention services, as well as organizational factors and staff attitudes that may influence POL intervention adoption. NGOs will then be randomized to one of three dissemination conditions: (1) a control condition in which only intervention print manuals are distributed;(2) a traditional face-to-face workshop training condition that provides manuals, an on-site NGO staff training workshop, and followup individualized telephone consultation on intervention implementation;or (3) a distance dissemination condition that provides NGO staff training comparable to the on-site workshop but that uses interactive and Internet-based distance training methods followed by individualized distance followup consultation. At 12- and 24-month followup points, telephone interviews assess NGO adoption of the disseminated intervention, determine the fidelity of new NGO programs to core elements of the disseminated model, and identify factors mediating or moderating adoption. We hypothesize that both the traditional face-to-face workshops and distance training methods will both result in greater provider adoption than that found in the control group and that the distance method will be more cost-effective. Because the distance modality lends itself well to repeated and """"""""refresher""""""""'training by NGO staff, a secondary hypothesis is that this modality will produce greater adoption than one-time workshops. The overarching goal of this research is to evaluate a prototype for an Internet-based """"""""virtual"""""""" training system infrastructure that can be used to facilitate rapid research-to-practice technology transfer of public health interventions to providers on a global scale.
