A multisite randomized trial of a motivational intervention targeting multiple risks in youth living with HIV: initial effects on motivation, self-efficacy, and depression.

TitleA multisite randomized trial of a motivational intervention targeting multiple risks in youth living with HIV: initial effects on motivation, self-efficacy, and depression.
Publication TypePublication
Year of Publication2010
AuthorsNaar-King S, Parsons JT, Murphy D, Kolmodin K, D Harris R
Corporate AuthorsATN 004 Protocol Team
JournalJ Adolesc Health
Volume46
Issue5
Pagination422-8
Date Published2010 May
ISSN1879-1972
KeywordsAdolescent, Depression, Female, Health Promotion, HIV Long-Term Survivors, Humans, Male, Motivation, Risk Factors, Risk Reduction Behavior, Self Efficacy, United States, Urban Population, Young Adult
Abstract

<p><b>PURPOSE: </b>Interventions targeting multiple risk behaviors are needed for youth living with HIV (YLH). A randomized clinical trial compared Healthy Choices, a four session motivational intervention targeting two of the three risk behaviors (HIV medication adherence, sexual risk behavior and substance use) to multidisciplinary specialty care alone. This article presents intermediary outcomes available at 3-month follow-up, variables proposed to be precursors to behavior change (motivation, self-efficacy, and depression).</p><p><b>METHODS: </b>YLH (N=186) with at least one of the three problem behaviors were recruited from four sites in the Adolescent Trials Network and one non-Adolescent Trials Network site, and were assessed at baseline and 3 months.</p><p><b>RESULTS: </b>Of the 94 youth randomly assigned to the treatment condition, 84% received at least one session, 67% received at least two sessions, 56% received at least three sessions, and 49% completed all four sessions. In intent-to-treat analysis, only depression was significantly improved in the treatment group as compared with controls. However, in per-protocol analysis, youth receiving at least two sessions of the intervention also showed significant improvements in motivational readiness to change as compared with youth in the control condition.</p><p><b>CONCLUSION: </b>Results suggest the potential benefits of clinic-based motivational interventions for YLH who access these interventions. Delivering interventions in the community using an outreach model may improve access. Analysis of subsequent time points will determine effects on actual behavior change.</p>

DOI10.1016/j.jadohealth.2009.11.198
Alternate JournalJ Adolesc Health
PubMed ID20413077
PubMed Central IDPMC2859210
Grant ListU01 HD040474 / HD / NICHD NIH HHS / United States
U01 HD040533 / HD / NICHD NIH HHS / United States
U01 HD040533-01 / HD / NICHD NIH HHS / United States
U01-HD040533 / HD / NICHD NIH HHS / United States