Bernadette Lalonde

Impact of HIV/AIDS Education on Health Care Provider Practice: Results from Nine Grantees of the Special Projects of National Significance Program

The study assessed the impact of health care provider HIV/AIDS education and training on patient care from nine Special Projects of National Significance. Telephone interviews were conducted with 218 health care providers within 8 months, on average, following completion of training. Respondents provided examples of how the SPNS trainings affected their provision of patient/client care. Transcribed comments reflecting change in patient/client care were classified by independent coders under 1 of 10 broad practice change categories. Eighty-two percent of the trainees identified at least one instance of change in patient/client care as a function of their training experience. Self-reported findings included changes in the number/types of patients seen, interpersonal interactions with patients/clients, HIV testing and counseling practices, patient/family education, infection control, advocacy, referrals and collaboration, documentation, and other service changes.

The impact of marital status and quality on family functioning in maternal chronic illness

Married individuals tend to enjoy greater health and well-being than nonmarried. However, investigators disagree about whether this is related to the quality of the marriage or to participation in the socially accepted role of marriage. In the present study, we examined the roles of marital quality and marital status as predictors of the familys adjustment processes in the context of maternal chronic illness. We found that the family functioning of single women and unhappily married women was similar and that happily married women enjoyed higher levels of family functioning and family coping. Unhappily married women reported more illness demands, particularly on their time and energy, than did happily married or single women. We suggest it is the quality of the marital interaction, and not the role benefits of marriage, that facilitates family adjustment under conditions of maternal chronic illness.

Outcomes associated with delirium in acutely hospitalized acquired immune deficiency syndrome patients.

The study demonstrates that delirium in acquired immune deficiency syndrome (AIDS) patients is associated with mortality, the need for long-term care, and an increased length of hospitalization. Data were collected prospectively on human immunodeficiency virus (HIV)/AIDS patients admitted to a teaching hospital from January 1996 through December 1996. The data included demographic characteristics of the participants, medical diagnoses, CD4 cell count, Karnofsky functional assessment, mortality during admission, length of stay, and discharge placement. Participants were evaluated throughout their hospital stay for evidence of delirium. The presence of delirium was determined using DSM-IV diagnostic criteria. There were no significant differences between delirious and nondelirious patients with respect to demographic characteristics or markers of medical morbidity. Patients with delirium were more likely to die during admission (chi-square [chi2] = 39.1, df = 1, P<.0010), to stay longer in hospital (t = 3.50, df = 12.9, P<.0041), or to need long-term care if discharged alive (chi2 = 12.8, df = 2, P<.0021). Delirium is associated with adverse outcomes in hospitalized AIDS patients. More research is needed to characterize the nature of this association.

A Process and Outcomes Evaluation of the International AIDS Conference: Who Attends? Who Benefits Most?

The objective of the study was to conduct a process and outcomes evaluation of the International AIDS Conference (IAC). Reaction evaluation data are presented from a delegate survey distributed at the 2004 IAC held in Thailand. Input and output data from the Thailand IAC are compared to data from previous IACs to ascertain attendance and reaction trends, which delegates benefit most, and host country effects. Outcomes effectiveness data were collected via a survey and intercept interviews. Data suggest that the host country may significantly affect the number and quality of basic science IAC presentations, who attends, and who benefits most. Intended and executed HIV work-related behavior change was assessed under 9 classifications. Delegates who attended 1 previous IAC were more likely to report behavior changes than attendees who attended more than 1 previous IAC. The conference needs to be continually evaluated to elicit the required data to plan effective future IACs.

Systems Change Resulting from HIV/AIDS Education and Training A Cross-Cutting Evaluation of Nine Innovative Projects

An evaluation of nine diverse HIV/AIDS training programs assessed the degree to which the programs produced changes in the ways that health care systems deliver HIV/AIDS care. Participants were interviewed an average of 8 months following completion of training and asked for specific examples of a resulting change in their health care system. More than half of the trainees gave at least one example of a systems change. The examples included the way patient referrals are made, the manner in which agency collaborations are organized, and the way care is delivered.

Trainee Characteristics and Perceptions of HIV/AIDS Training Quality.

HIV/AIDS education and training have played a vital role in keeping health providers up to date on emerging developments and approaches. This study reports findings from seven HIV/AIDS education and training projects. Participants in more than 600 training sessions described themselves, their professional background, and their general reasons for taking the training. Immediately following the training, they also rated the quality of their educational experience along several dimensions. Trainee characteristics were related to assessments of training quality, using a regression decision-tree analytic approach. Although effect sizes were generally small, quality ratings of the HIV/AIDS training experiences were associated with certain projects, basic trainee demographic characteristics, professional background, and experience in the HIV field. Greater understanding about participant characteristics can provide clues about how these training experiences are perceived and processed and may inform decision making about instructional HIV/AIDS curricula.

Outcome Effectiveness of the Wallingford Wellness Project

Research evidence on younger populations has demonstrated that lifestyle habits affecting the incidence and severity of chronic illness and disease can be changed in health enhancing directions via health promotion programs offering instruction in physical fitness, stress management, nutrition, and environmental awareness. The Wallingford Wellness Project extended this research by developing a health promotion program for the elderly based on these components. Experimental and comparison groups were matched in terms of age, sex, marital status, socio-economic status, psychosocial and physical health levels. The outcome effectiveness of the program was evaluated via a questionnaire administered prior to intervention, immediately following the 21 week program, and 6 months later. Results confirm the effectiveness of the program in promoting and sustaining information, attitude, and behavior change in persons over 54 years of age.