Challenges and opportunities in the science of research to practice: lessons learned from a randomized controlled trial of a sexual risk-reduction intervention for psychiatric patients in a public mental health system
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
;
42(4): 349-359, July-Aug. 2020. tab, graf
Article
in English
| LILACS
| ID: biblio-1132089
ABSTRACT
Objective:
Human immunodeficiency virus (HIV) prevention efficacy trials with psychiatric patients have been conducted in research settings in high-resourced countries, establishing short-term efficacy for reducing sexual risk behavior. None has been implemented within systems of care. In the last decade, overcoming this research-to-practice gap has become a focus of implementation science. This paper describes the first and only HIV Prevention intervention trial for psychiatric patients conducted in real-world outpatient psychiatric settings facilitated by trained clinic-based providers.Methods:
The HIV Prevention intervention, which uses the Information-Motivation-Behavioral Skills model to achieve sexual risk-reduction, was rigorously adapted to the local context and clinic services' needs. Participants from eight clinics were randomized to HIV Prevention or Health Promotion conditions.Results:
HIV Prevention participants showed significant improvement in Information-Motivation-Behavioral domains; in this group, behavioral intentions were associated with significantly fewer unprotected sex occasions, but reduction of unprotected sex occasions was similar in both conditions.Conclusion:
Our trial was conducted before implementation studies became widely funded. Transporting an intervention to a new culture or into real-world practice settings may require adaptations. Our results demonstrate that clear guidelines are needed regarding whether to conduct efficacy, effectiveness, and/or implementation research as the most appropriate next step. Clinical trial registration NCT00881699
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Sexual Behavior
/
HIV Infections
/
Randomized Controlled Trials as Topic
/
Mental Health
/
Community Mental Health Services
/
Mentally Ill Persons
/
Risk Reduction Behavior
Type of study:
Controlled clinical trial
/
Etiology study
/
Practice guideline
/
Risk factors
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
Journal subject:
Psychiatry
Year:
2020
Type:
Article
Affiliation country:
Brazil
/
United States
/
United kingdom
Institution/Affiliation country:
Columbia University/US
/
George Washington University/US
/
Universidade Federal de Minas Gerais (UFMG)/BR
/
Universidade Federal do Estado do Rio de Janeiro (UNIRIO)/BR
/
Universidade Federal do Rio de Janeiro (UFRJ)/BR
/
University of Leeds/GB
/
University of Southern California/US
/
University of Wisconsin-Milwaukee/US
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