PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 9625896

Adapting an effective primary care provider STD/HIV prevention training programme.

D L Rabin
View original source ↗Export metadata ↓

Abstract

Sexually acquired human immunodeficiency virus (HIV) infection continues to be the major source of HIV infection in the USA. Preventing sexual transmission of HIV can be accomplished through patient behaviour change. Such behaviour change can also decrease risk of other sexually transmitted diseases (STDs) and unwanted pregnancies, both far more common problems than HIV infection. Primary care physicians and other providers can increase patients' safe sex practices by conducting effective sexual risk assessment (RA) and risk reduction (RR) counselling, but physicians both infrequently and incompletely do sexual RA and RR. A programme was developed to improve primary care physicians' prevention practice using Simulated Patient Instructors (SPIs) and mailed educational materials. Programme evaluations showed improved sexual RA and RR practice both by self-report as well as by observation by Simulated Patient Evaluators (SPEs). This paper briefly reviews these findings and then presents adaptations made to improve the programme's content, decrease its cost and increase its availability for training many other care providers. Evaluation of the adapted programme indicates that content and training methods are highly regarded by a diverse array of trainees. To disseminate the modified programme beyond the local area, a Train-the-Trainer programme and manual have been developed, including discussion of recruiting, training and using SPIs for sexual risk reduction. Wider use of this training, as well as more effective and more readily available STD/HIV prevention training, are needed to attain national goals of provider clinical prevention practice.

Explore related subjects

Costs and Cost AnalysisCurriculumDistrict of ColumbiaEducation, Medical, GraduateHIV InfectionsHumansProgram EvaluationSexually Transmitted DiseasesTeachingVenereologyJournal ArticleResearch Support, Non-U.S. Gov'tResearch Support, U.S. Gov't, P.H.S.

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

D L Rabin. 1998. Adapting an effective primary care provider STD/HIV prevention training programme.. https://doi.org/10.1080/09540129850124389

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

Predicting costs of mental health care: a critical literature review.

BACKGROUND: Cost evaluation research in the mental health field is being increasingly recognized as a way to achieve a more effective deployment of scarce resources. However, there is a paucity of studies that seek to identify predictors of psychiatric service utilization and costs. This paper aims to critically review the published research in the field of psychiatric service utilization and costs, and discusses current methodological developments in this field. METHOD: Sixteen studies were identified and are critically reviewed. RESULTS: No single variable alone can explain variations in costs between patients; instead, a range of different clinical and non-clinical variables provides a greater explanation of cost variations. Having a history of previous psychiatric service use is the most consistent predictor of higher psychiatric costs. Only one study considers indirect costs incurred by users, their families and friends and society as a whole, with the remaining 15 studies focusing on direct mental health care costs. There is a lack of studies that consider the future psychiatric service utilization and costs of care of children and older people. The cross-validation of predictive models is not yet routine, with only four of the studies including a cross-validation procedure. CONCLUSIONS: The predictive approach in mental health cost evaluation has relevance for both mental health policy and practice. However, there is a paucity of studies that focus on children, older people and indirect costs. Furthermore, there remain a number of methodological challenges to address.

Costs and Cost Analysis↗
PubMed2007

The increasing cost of the basic foods required to promote health in Queensland.

OBJECTIVE: To assess changes in the cost and availability of a standard basket of healthy food items (the Healthy Food Access Basket [HFAB]) in Queensland over time. DESIGN AND PARTICIPANTS: A series of four cross-sectional surveys (in 1998, 2000, 2001 and 2004) describing the cost and availability of foods in the HFAB over time. In the latest survey, 97 Queensland food stores across the five Australian Bureau of Statistics remoteness categories were compared. MAIN OUTCOME MEASURES: Cost comparisons for HFAB items by remoteness category for the 97 stores surveyed in 2004; changes in cost and availability of foods in the 81 stores surveyed since 2000; comparisons of food prices in the 56 stores surveyed in 1998, 2000, 2001 and 2004. RESULTS: In 2004, the Queensland mean cost of the HFAB was $395.28 a fortnight. The cost of the HFAB was 29.6% ($113.89) higher in "very remote" areas than in "major cities" (P < 0.001). Between 2001 and 2004, the Queensland mean cost of the HFAB increased by 14.0% ($48.45), while in very remote areas the cost increased by 18.0% ($76.93) (P < 0.001). Since 2000, the annualised per cent increase in cost of the HFAB has been higher than the increase in Consumer Price Index for food in Brisbane. The cost of healthy foods has risen more than the cost of some less nutritious foods, so that the latter are now relatively more affordable. CONCLUSIONS: Consumers, particularly those in very remote locations, need to pay substantially more for basic healthy foods than they did a few years ago. Higher prices are likely to be a barrier to good health among people of low socioeconomic status and other vulnerable groups. Interventions to make basic healthy food affordable and accessible to all would help reduce the high burden of chronic disease.

Costs and Cost Analysis↗