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
Artigo
em Inglês
| 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
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LILACS (Américas)
Assunto principal:
Comportamento Sexual
/
Infecções por HIV
/
Ensaios Clínicos Controlados Aleatórios como Assunto
/
Saúde Mental
/
Serviços Comunitários de Saúde Mental
/
Pessoas Mentalmente Doentes
/
Comportamento de Redução do Risco
Tipo de estudo:
Ensaio Clínico Controlado
/
Estudo de etiologia
/
Guia de Prática Clínica
/
Fatores de risco
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Braz. J. Psychiatry (São Paulo, 1999, Impr.)
Assunto da revista:
Psiquiatria
Ano de publicação:
2020
Tipo de documento:
Artigo
País de afiliação:
Brasil
/
Estados Unidos
/
Reino Unido
Instituição/País de afiliação:
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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