Journal
TRANSLATIONAL BEHAVIORAL MEDICINE
Volume 1, Issue 2, Pages 313-326Publisher
OXFORD UNIV PRESS
DOI: 10.1007/s13142-011-0043-1
Keywords
Family-based interventions; HIV prevention; HIV management; Families affected by HIV; Evidence-based interventions; Behavioral skills; Common elements; Core elements; Replication
Categories
Funding
- National Institute of Mental Health [P30 MH 58107, R01 MH0775533]
- National Institute of Alcohol and Alcohol Abuse [R01 AA017104-01A1]
- National Institute of Nursing Research [R01-NR009922-01]
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Family-based interventions are efficacious for human immunodeficiency virus (HIV) detection, prevention, and care, but they are not broadly diffused. Understanding intervention adaptation and translation processes can support evidence-based intervention (EBI) diffusion processes. This paper provides a narrative review of a series of EBI for families affected by HIV (FAH) that were adapted across five randomized controlled trials in the US, Thailand, and South Africa over 15years. The FAH interventions targeted parents living with HIV and their children or caregiver supports. Parents with HIV were primarily mothers infected through sexual transmission. The EBIs for FAH are reviewed with attention to commonalities and variations in risk environments and intervention features. Frameworks for common and robust intervention functions, principles, practice elements, and delivery processes are utilized to highlight commonalities and adaptations for each location, time period, and intervention delivery settings. Health care, housing, food, and financial security vary dramatically in each risk environment. Yet, all FAH face common health, mental health, transmission, and relationship challenges. The EBIs efficaciously addressed these common challenges and were adapted across contexts with fidelity to robust intervention principles, processes, factors, and practices. Intervention adaptation teams have a series of structural decision points: mainstreaming HIV with other local health priorities or not; selecting an optimal delivery site (clinics, homes, community centers); and how to translate intervention protocols to local contexts and cultures. Replication of interventions with fidelity must occur at the level of standardized functions and robust principles, processes, and practices, not manualized protocols. Adopting a continuous quality improvement paradigm will enhance rapid and global diffusion of EBI for FAH.
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