ABSTRACT
Family-based interventions are efficacious for human immunodeficiency virus (HIV) detection, prevention, and care, but they
are not broadly diffused. Understanding intervention adaptation and translation processes can support evidence-based intervention
(EBI) diffusion processes. This paper provides a narrative review of a series of EBI for families affected by HIV (FAH) that
were adapted across five randomized controlled trials in the US, Thailand, and South Africa over 15 years. The FAH interventions
targeted parents living with HIV and their children or caregiver supports. Parents with HIV were primarily mothers infected
through sexual transmission. The EBIs for FAH are reviewed with attention to commonalities and variations in risk environments
and intervention features. Frameworks for common and robust intervention functions, principles, practice elements, and delivery
processes are utilized to highlight commonalities and adaptations for each location, time period, and intervention delivery
settings. Health care, housing, food, and financial security vary dramatically in each risk environment. Yet, all FAH face
common health, mental health, transmission, and relationship challenges. The EBIs efficaciously addressed these common challenges
and were adapted across contexts with fidelity to robust intervention principles, processes, factors, and practices. Intervention
adaptation teams have a series of structural decision points: mainstreaming HIV with other local health priorities or not;
selecting an optimal delivery site (clinics, homes, community centers); and how to translate intervention protocols to local
contexts and cultures. Replication of interventions with fidelity must occur at the level of standardized functions and robust
principles, processes, and practices, not manualized protocols. Adopting a continuous quality improvement paradigm will enhance
rapid and global diffusion of EBI for FAH.
are not broadly diffused. Understanding intervention adaptation and translation processes can support evidence-based intervention
(EBI) diffusion processes. This paper provides a narrative review of a series of EBI for families affected by HIV (FAH) that
were adapted across five randomized controlled trials in the US, Thailand, and South Africa over 15 years. The FAH interventions
targeted parents living with HIV and their children or caregiver supports. Parents with HIV were primarily mothers infected
through sexual transmission. The EBIs for FAH are reviewed with attention to commonalities and variations in risk environments
and intervention features. Frameworks for common and robust intervention functions, principles, practice elements, and delivery
processes are utilized to highlight commonalities and adaptations for each location, time period, and intervention delivery
settings. Health care, housing, food, and financial security vary dramatically in each risk environment. Yet, all FAH face
common health, mental health, transmission, and relationship challenges. The EBIs efficaciously addressed these common challenges
and were adapted across contexts with fidelity to robust intervention principles, processes, factors, and practices. Intervention
adaptation teams have a series of structural decision points: mainstreaming HIV with other local health priorities or not;
selecting an optimal delivery site (clinics, homes, community centers); and how to translate intervention protocols to local
contexts and cultures. Replication of interventions with fidelity must occur at the level of standardized functions and robust
principles, processes, and practices, not manualized protocols. Adopting a continuous quality improvement paradigm will enhance
rapid and global diffusion of EBI for FAH.
- Content Type Journal Article
- Pages 1-14
- DOI 10.1007/s13142-011-0043-1
- Authors
- Mary Jane Rotheram-Borus, Center for HIV Identification, Prevention, and Treatment Services, AIDS Institute, University of California, Los Angeles, Los Angeles, CA, USA
- Dallas Swendeman, Center for HIV Identification, Prevention, and Treatment Services, AIDS Institute, University of California, Los Angeles, Los Angeles, CA, USA
- Sung-Jae Lee, Center for HIV Identification, Prevention, and Treatment Services, AIDS Institute, University of California, Los Angeles, Los Angeles, CA, USA
- Li Li, Center for HIV Identification, Prevention, and Treatment Services, AIDS Institute, University of California, Los Angeles, Los Angeles, CA, USA
- Bita Amani, Center for HIV Identification, Prevention, and Treatment Services, AIDS Institute, University of California, Los Angeles, Los Angeles, CA, USA
- Myralyn Nartey, Center for HIV Identification, Prevention, and Treatment Services, AIDS Institute, University of California, Los Angeles, Los Angeles, CA, USA
- Journal Translational Behavioral Medicine
- Online ISSN 1613-9860
- Print ISSN 1869-6716