The proposed AIDS-FIRCA research will adapt, implement, and test a peer group intervention to mobilize Chilean health workers as HIV/AIDS prevention leaders. The intervention was first developed in Botswana, then adapted for school teachers in Malawi, and now is being used to train health workers, community adults, and adolescents in Malawi. Health workers are key to success in the struggle to contain the HIV/AIDS pandemic. Chile has an incipient AIDS epidemic, but the epidemic is now spreading to the general population, beyond traditional high-risk groups. Very few efforts are now directed at containing the epidemic or preparing health workers for a role in HIV prevention. This model of peer group leader training for health worker mobilization is low cost and sustainable, and highly relevant for Chile and the Latin American region. The Chile research will be a partial replication of the Malawi study. In Phase I, a formative evaluation using focus groups and interviews with health administrators and workers will allow us to tailor the intervention and evaluation instruments for health workers in Chile. A quasi-experiment with pretest and post-test observations of health workers and clients in five intervention clinics and five comparable control clinics will evaluate the effects of the intervention. Process evaluation will document quality of the intervention. Health worker-client observations and interviews with health workers pre and post intervention in five intervention and five delayed-intervention control clinics will allow us to test hypotheses about changes in health services and health workers at three months post-intervention. Health services outcomes include: consistent practice of universal precautions, showing sensitivity toward HIV-related concerns, and incorporation of HIV prevention messages. Health worker outcomes include: increased HIV/AIDS knowledge, more positive attitudes toward persons living with HIV/AIDS and toward HIV prevention, and increased HIV prevention behaviors at work and in their personal lives. Power analysis indicates that the sample of 457 workers per clinic, with an 80% participation rate, will be adequate to test small to medium expected effects at a power of 0.80. Results will be disseminated to health workers and policy makers. Full participation by four Chilean coinvestigators and workshops by the US team will build research capacity at the host institution. The intervention is a low-cost sustainable model for national mobilization of health workers for HIV prevention. ? ?
| Ferrer, Lilian; Bernales, Margarita; Cianelli, Rosina et al. (2015) Mano a Mano for health professions students in Chile: a pilot HIV prevention program. J Assoc Nurses AIDS Care 26:680-8 |
| Norr, Kathleen F; Ferrer, Lilian; Cianelli, Rosina et al. (2012) Peer group intervention for HIV prevention among health workers in Chile. J Assoc Nurses AIDS Care 23:73-86 |
| Valdés, Baltica Cabieses; Lagunas, Lilian Ferrer; Villarroel, Luis Antonio et al. (2011) HIV/AIDS knowledge and occupational risk in primary care health workers from Chile. Invest Educ Enferm 29:212-221 |
| Ferrer, Lilian; Cabieses, Baltica; Norr, Kathleen et al. (2011) [Effectiveness of an educational program about the Chilean AIDS law in primary care health workers]. Rev Med Chil 139:625-32 |
| Valdés, Baltica Cabieses; Lagunas, Lilian Ferrer; Villarroel, Luis Antonio et al. (2011) [HIV/AIDS knowledge and occupational risk in primary care health workers from Chile]. Invest Educ Enferm 29:212-221 |
| Ferrer, Lilian Marcela; Cianelli, Rosina; Norr, Kathleen F et al. (2009) Observed use of standard precautions in Chilean community clinics. Public Health Nurs 26:440-8 |
