耷拉下来,库尔思TY -的盟安E盟——Chhun Nok AU -克莱兰德,查尔斯M盟——Crespo-Fierro米歇尔盟——Pares-Avila穆盟——Lizcano,约翰AU -诺曼,罗伯特·G AU - Shedlin米歇尔·G AU -约翰斯顿,芭芭拉·E AU -夏普,维多利亚L PY - 2016 DA - 2016/07/13 TI -语言和文化适应的计算机咨询项目(护理+西班牙语)支持HIV治疗依从性和对艾滋病毒感染者/艾滋病风险降低:一项随机对照试验JO - J Med Internet Res SP - e195 VL - 18 IS - 7kw -抗逆转录病毒治疗依从性KW -基于计算机的咨询KW -文化适应KW -艾滋病毒KW -语言适应KW -阳性预防KW -技术接受模型KW -病毒载量AB -背景:美国的人类免疫缺陷病毒(HIV)疾病对少数民族的影响尤其严重，包括拉丁美洲人。在拉丁美洲人中，包括语言在内的障碍与抗逆转录病毒治疗(ART)依从性较低有关，但抗逆转录病毒治疗和临床就诊依从性干预很少用西班牙语开发或提供。目的:目的是采用一种基于计算机的咨询工具，在英语成年人人群中降低HIV-1病毒载量和性风险传播，用于艾滋病毒阳性的西班牙语人群的常规临床访问(CARE+西班牙语);技术接受模型(TAM)是指导程序开发的理论框架。方法:于2010年6月4日至2012年3月29日进行纵向随机对照试验。参与者从纽约市由三家诊所组成的综合艾滋病毒治疗中心招募。资格标准是(1)成人(年龄≥18岁)，(2)拉丁裔出生或血统，(3)会说西班牙语(单语或多语)，(4)使用抗逆转录病毒药物。线性和广义混合线性效应模型用于分析主要结果，包括抗逆转录病毒治疗依从性、性传播风险行为和HIV-1病毒载量。对有意选择的干预参与者进行了退出访谈，以探讨参与者对该工具的文化接受度，焦点小组使用TAM框架探讨了诊所提供者的接受度和系统效率问题。 Results: A total of 494 Spanish-speaking HIV clinic attendees were enrolled and randomly assigned to the intervention (arm A: n=253) or risk assessment-only control (arm B, n=241) group and followed up at 3-month intervals for one year. Gender distribution was 296 (68.4%) male, 110 (25.4%) female, and 10 (2.3%) transgender. By study end, 433 of 494 (87.7%) participants were retained. Although intervention participants had reduced viral loads, increased ART adherence and decreased sexual transmission risk behaviors over time, these findings were not statistically significant. We also conducted 61 qualitative exit interviews with participants and two focus groups with a total of 16 providers. Conclusions: A computer-based counseling tool grounded in the TAM theoretical model and delivered in Spanish was acceptable and feasible to implement in a high-volume HIV clinic setting. It was able to provide evidence-based, linguistically appropriate ART adherence support without requiring additional staff time, bilingual status, or translation services. We found that language preferences and cultural acceptability of a computer-based counseling tool exist on a continuum in our urban Spanish-speaking population. Theoretical frameworks of technology’s usefulness for behavioral modification need further exploration in other languages and cultures. Trial Registration: ClinicalTrials.gov NCT01013935; https://clinicaltrials.gov/ct2/show/NCT01013935 (Archived by WebCite at http://www.webcitation.org/6ikaD3MT7) SN - 1438-8871 UR - //www.mybigtv.com/2016/7/e195/ UR - https://doi.org/10.2196/jmir.5830 UR - http://www.ncbi.nlm.nih.gov/pubmed/27417531 DO - 10.2196/jmir.5830 ID - info:doi/10.2196/jmir.5830 ER -