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An Online Library of Science-Based HIV Prevention Resources

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DOI: 10.4236/wja.2018.84010    21 Downloads   52 Views  

ABSTRACT

This paper introduces the online Sociometrics Social, Behavioral, and Health Sciences Library, an exciting new science-based resource for HIV/AIDS researchers, health educators, and clinicians. The over 400 products in the Sociometrics Library supplement the online publications—journal articles, books, reports, monographs—that have been the focus of scientific research libraries and publishers to date, both printed and online. Examples of the innovative science-based products that serve as the library’s content include: Evidence-based interventions and programs (EBIs/EBPs) that evaluation research has shown to be effective in preventing HIV or its risky social and behavioral antecedents; primary research data and survey instruments; and interactive, multimedia training tools and courses to build HIV professionals’ capacity to implement EBPs with fidelity and to cooperate with evaluators in the assessment of their effectiveness. A Scientist Expert Panel has guided and will continue to guide product selection and acquisition, ensuring the collection’s continuing technical merit, research utility, and relevance for practice and policy. The Sociometrics Library aims to become the dominant online source of behavioral and social science-based HIV research by-products, operationally sustainable and able to stay up-to-date both from a technological and scientific perspective.

1. Introduction

Despite global efforts to address the AIDS epidemic, HIV infection remains a significant problem, particularly for low-resource countries and US minority populations who are disproportionately carrying the HIV burden [1] [2] [3] . AIDS and related illnesses are the leading cause of death among women ages 15 to 49 globally, and the second leading cause of death for young women ages 15 to 24 in Africa [4] . While AIDS-related deaths have declined in some regions of the world, including eastern and southern Africa and North America, AIDS-related mortality has increased over the past decade in the Middle East and North Africa by 48%, and in Eastern Europe and Central Asia by 38% [4] .

The populations most profoundly affected by the HIV epidemic include specific racial and ethnic minority groups, gay or bisexual men who have sex with other men (MSM), sex workers, and injection drug users. In countries across the world, HIV prevalence among key subpopulations is often substantially higher than among the general population [4] . In the United States, MSM accounted for 67% of new HIV infections and 83% of new infections in males in 2016 [5] . Among racial and ethnic groups in the US, African American and Hispanic men and women continue to be at higher risk of contracting HIV and yet have lower access to testing, prevention, and healthcare [2] [3] [6] . According to the CDC, the US Centers for Disease Control and Prevention, African Americans and Hispanics represent 30% of the US population but accounted for 69% of new HIV infections in 2016 [5] .

Evidence-Based Resources for Reducing HIV Transmission

As a result, numerous programs and strategies have been developed across the globe to reduce HIV transmission and improve related outcomes [7] [8] [9] [10] [11] . Many such programs have been proven effective in changing behaviors, such as risky sexual or injection drug-related behaviors, that increase the probability of HIV transmission [12] - [17] . These effective programs are called evidence-based interventions (EBIs) or evidence-based programs (EBPs). Typically, EBPs not only inform participants with relevant knowledge and facts, but also teach new skills and give participants the opportunity to practice the skills with techniques like modeling, role-playing, and games.

Considerable research has demonstrated that select EBPs can decrease risky sexual and drug-use behaviors among populations heavily impacted by HIV/AIDS, including men who have sex with men [18] [19] [20] ; injection drug users [21] [22] ; young people [23] ; and other high-risk populations. This is true in both high- and low-resource countries [24] [25] [26] [27] and across age groups such as youth and adults [28] [29] [30] . The success of EBPs in reducing HIV transmission among diverse populations, including high risk groups, has led organizations such as the CDC, NIH (the US National Institutes of Health), and WHO (the World Health Organization) to actively promote the use of EBPs [31] [32] [33] [34] .

Many factors, however, continue to obstruct EBPs’ wide dissemination and sustained implementation [33] [35] [36] [37] [38] . The most prominent barriers to EBP uptake and implementation are the lack of low-cost access to EBPs; the high cost and lack of availability of technical assistance; insufficient organizational capacity among community-based organizations implementing the EBPs; inadequate buy-in among staff; a lack of EBP fit with the personnel, money and time constraints of the organization; and limited knowledge about adaptation of EBPs to the local context [35] [38] [39] . Public health practitioners frequently report that they are stretched too thin. They are often expected to remain up-to-date on literature, seek out effective programs, perform program adaptations for their specific target audiences, and find other practitioners to share lessons learned from the field or exchange advice. Each step of the process requires a considerable time commitment from already busy health educators and providers, creating significant challenges.

Program adaptation to the local context can be a particularly weighty barrier, given the difficulty in determining how to adapt a program for new contexts while preserving the core components underlying the program’s efficacy. However, program adaptation is itself an essential practice, as research has shown that programs must be tailored to appropriately address the cultural backgrounds, developmental levels, and community contexts of the target population [40] [41] . While adaptations are vital to an EBP’s on going success, inappropriate modification of program components often reduces a program’s efficacy and prevents it from changing behavior. Studies have shown that organizations frequently modify core program content [42] [43] [44] . Practitioners lack helpful, easily understood, science-based tools to help them apply the concepts of fidelity and flexibility to their work [45] [46] . Modifications are often made to adapt, alter or delete program content, scope, and/or delivery method to accommodate real-world circumstances such as time constraints, varying population or setting needs, or unavailability of organizational resources. Many such modifications are done without guidance for how the changes affect fidelity, core elements and desired outcomes [47] [48] .

New tools and resources are required to bridge the gap between research and practice. There is a need not only for widespread identification and dissemination of EBPs, but also for tools and resources that support program fidelity, appropriate adaptation of EBPs to specific contexts, and program engagement.

Program evaluation is also of significance. Evaluation enables practitioners to understand why and in what areas their implementation of an EBP has succeeded or failed, the impact of each program component, and how to improve future implementations [49] . However, health practitioners often experience difficulty in evaluating their interventions because of factors such as a lack of research knowledge and training; difficulty developing questionnaires and other evaluation tools; lack of staff time to conduct evaluations; and low funding coupled with high evaluation costs [50] [51] .

To address these challenges, Sociometrics Corporation has developed an online suite of research-based products and resources: the Sociometrics Social, Behavioral, and Health Sciences Library (https://www.socio.com/). This online library aims to address these challenges by expanding and updating the search for effective HIV prevention EBPs and HIV-related datasets; identifying EBPs that meet established effectiveness criteria; promoting easy dissemination and uptake of these EBPs across implementation settings, including low-resource regions; providing capacity-building tools that support program adaptation and fidelity; and enabling widespread evaluation of program efficacy by simplifying data collection, analysis, and sharing.

2. Methods

2.1. Collection of Resources

For over three decades, with funding from the NIH and CDC, Sociometrics has developed multiple topically-focused collections of evidence-based programs (EBPs), datasets, and capacity-building tools for health and public health professionals. Two of these collections―the HIV/AIDS Prevention Program Archive (HAPPA) and the Global HIV Archive (GHA)―contain EBPs that have been proven effective in reducing the sexual and drug-related behaviors that put one at risk of HIV/AIDS/STI transmission. The companion HIV/AIDS/STI Data Archive includes studies that provide descriptive and comparative data on the behavioral and social antecedents and consequences of HIV, AIDS, and sexually transmitted infections (STIs). Sociometrics has also developed capacity-building tools to aid in implementing, adapting, and evaluating EBPs.

2.1.1. EBP and Data Collections

Sociometrics’ collections of EBPs and datasets were developed using a systematic process of identification (by Sociometrics staff), review and selection (by Scientist Expert Panels), acquisition (from the developer of the EBP or dataset) and processing for public use (by Sociometrics staff). A Scientist Expert Panel of four to six members was established for each topically-focused collection; panelists were researchers considered experts in the topic area. The Scientist Expert Panels developed resource selection criteria in conjunction with Sociometrics’ staff of scientists. For EBPs, these criteria included the program’s technical merit, replicability, and positive outcomes; the criteria for datasets included technical quality, substantive utility, relevance, and disciplinary balance. Candidate programs and datasets were then identified using extensive searches of relevant scientific literature, and briefing materials were prepared for each candidate resource. These briefing materials were provided to the Scientist Expert Panels, who assigned each resource a priority score for inclusion in Sociometrics’ Library. Sociometrics contacted the developer(s), author(s), and/or investigator(s) of the selected programs or datasets to obtain permission to include the resource in the Sociometrics Library and to disseminate it for public use. Finally, obtained resources were packaged in a user-friendly way to facilitate replication in a new setting. For EBPs, packaging included a user’s guide containing the curriculum and describing the evidence for its effectiveness; as well as all facilitator, participant, and evaluation materials needed to faithfully replicate and evaluate the program in a new setting. For datasets, the packaging included a user’s guide describing the dataset’s sample, data collection methods, and included variables. The raw data and analytic SAS and SPSS program statements were included, as were documentation files such as instruments, codebooks, and frequencies.

2.1.2. Capacity-Building Tools

To support the exemplary EBP and data collections, Sociometrics’ scientists developed capacity-building tools and resources for ongoing education of HIV professionals. These tools aim to improve health practitioners’ ability to implement EBPs with fidelity and cultural competence, evaluate them, and analyze the resulting data. Resources in the capacity-building collection include training modules focused on how to implement and evaluate specific EBPs; sexual health-related activities and exercises for use in middle and high school classrooms; behavioral skills training tools for developing and implementing culturally competent programs; and evaluation resource guides and tutorials.

3. Results

3.1. Library Content

As of this writing, the Sociometrics Social, Behavioral, and Health Sciences Library (https://www.socio.com/) consists of 90 evidence-based programs, 315 datasets, and 22 capacity-building tools for health professionals. HIV/AIDS is a significant focus of the Sociometrics Library: 65 evidence-based programs (Table 1), 29 datasets (Table 2), and 16 capacity-building tools (Table 3) are focused on HIV and HIV prevention. The collection continues to grow. For information on how to submit a science-based HIV dataset, EBP, or capacity-building tool to the Sociometrics Library, please go to https://www.socio.com/submissions.

3.1.1. Evidence-Based HIV Prevention Programs

Table 1 details the HIV-related evidence-based programs (EBPs) in the online Sociometrics Library. A wide variety of programs are included, focused on different countries, target populations, theories of change, and prevention approaches. All of the HIV EBPs have demonstrated a positive impact on reducing sexual and/or injection drug-related behavior(s) that put an individual at risk for transmitting or getting HIV/AIDS. The EBPs are presented in lesson-by-lesson sequence, with all facilitator and participant materials for each session included in view- and/or download-format.

3.1.2. Exemplary Datasets

The Sociometrics Library’s datasets address a variety of topics including the incidence and prevalence of specific sexual behaviors; contraceptive and STI-preventive

Table 1. Evidence-based programs (EBPs) in the Sociometrics Library with a topical focus on HIV/AIDS prevention.

1Abbreviations used for Target Populations: African American (AA), Asian and Pacific Islander (API), Hispanic (HIS), Lesbian/Gay/Bisexual/Transgender (LGBT), Gay/Bisexual (GB). 2Additional information on all these programs can be found at https://www.socio.com/ or by clicking on the hyperlinked Program Name in the table.

Table 2. Datasets in the Sociometrics Library with a topical focus on HIV/AIDS/STIs.

1Abbreviations used for Target Populations: African American (AA), Asian and Pacific Islander (API), Hispanic (HIS), Lesbian/Gay/Bisexual/Transgender (LGBT), Gay/Bisexual (GB). 2Additional information on all these programs can be found at https://www.socio.com/ or by clicking on the hyperlinked Program Name in the table.

Table 3. Capacity-building tools for HIV professionals in the Sociometrics Library.

behavior; attitudes and beliefs regarding sexual behavior; HIV/AIDS-related knowledge, attitudes, behaviors, and serostatus; current and past episodes of STIs; and other high-risk behaviors, including alcohol/drug use and prostitution. Included for each dataset are the raw data in ASCII and CSV format, questionnaires, codebooks, frequencies, and SPSS and SAS analytic statements for statistical analysis of datasets. Many different papers have been written analyzing the datasets in Table 2, with various findings. These papers are not included in the Sociometrics Library, but can be readily found on databases such as PubMed and Google Scholar.

3.1.3. Capacity-Building Tools for HIV Professionals

The Sociometrics Library offers 16 capacity-building tools aimed at HIV professionals. These resources aim to increase the capacity of HIV educators and prevention providers to adapt, implement, and evaluate HIV prevention programs successfully. Some focus on specific HIV-related EBPs, while others focus on HIV risk reduction more generally. Some are offered in PDF format and others in interactive, multimedia format. Table 3 details the capacity-building resources for HIV professionals available in the Sociometrics Library.

3.2. Access

The evidence-based HIV/AIDS EBPs, datasets, and capacity-building tools in Tables 1-3 above can be accessed through individual, group, and institutional subscriptions (contact jjcard@socio.com for access information). Individual subscriptions allow a single health professional or practitioner to access, view, and administer one or more Library resources 24/7 from their computer, tablet, or smartphone. Group subscriptions allow a team of health professionals, researchers, and educators access, view and administration privileges. A group administrator can purchase access for team members and manage access centrally. Finally, an institutional all-access pass can be purchased by community-based organizations, hospitals and health clinics, universities, public health departments, and other interested institutions. This institutional all-access pass grants access to the entire resource library of 400+ EBPs, datasets, and capacity-building tools in https://www.socio.com/.

4. Discussion

The Sociometrics Library is a significant step forward in meeting the research-to-practice needs of frontline HIV prevention practitioners. In order to have a positive impact in the real-world, this library was built on the latest scientific knowledge, duly translated into formats accessible to global workers trying to stem the epidemic. The Sociometrics Library has many innovations, all aimed at facilitating real-world impact:

1) Identification and archiving of HIV prevention programs that science has found to be efficacious in reducing behaviors putting one at risk of HIV transmission. The collection of these validated prevention programs in one place saves health professionals valuable time and costs otherwise spent remaining up-to-date on the prevention literature and seeking out ways to access complete versions of the effective curriculum and implementation materials. The Sociometrics Library of replication-ready resources simplifies a process that currently presents a significant barrier to the use of evidence-based programs by HIV prevention practitioners.

2) Identification and archiving of datasets that science has found to be of high technical merit. The collection of the exemplary HIV/AIDS datasets in one place saves health researchers valuable time and costs otherwise spent remaining up-to-date on the prevention literature and seeking out the best ways to access the data on which publications were based. The Sociometrics Library of analysis-ready raw data and documentation simplifies a process that currently presents a significant barrier to secondary analysis of exemplary data by HIV prevention researchers.

3) Digitization and organization of effective program implementation materials to facilitate global access via the Internet. This innovation allows formerly printed, hard-copy educational products to be accessed at low cost anytime, any place. Health educators can now access prevention programs live during program implementation from their computer, tablet, or mobile phone. The curricula and materials are organized in lesson-by-lesson sequence, enabling easy use of the materials in schools, community-based organizations, clinics and hospitals.

4) Provision of capacity-building tools. The Sociometrics Library also includes science-based capacity-building and professional education tools that directly address some of the most significant challenges that prevention practitioners face when applying science-based research. These tools assist with adaptation of evidence-based programs to local settings, while maintaining the core program elements underlying the program’s effectiveness. Other tools describe how to appropriately evaluate prevention efforts and analyze research datasets.

5) Provision of online browsing, search, and filtering capabilities to improve users’ ability to find and select relevant products. The Sociometrics Library not only gathers effective programs, datasets, and capacity-building tools in one place, but also enables easy search and navigation within the library itself. Keyword search and filter capabilities by topic, target population, and product type allow users to quickly and easily find the most relevant product(s) for their needs.

6) Provision of original evaluation instruments. In order to encourage re-evaluation of the efficacious programs in a new setting, the Sociometrics Library also includes the original evaluation instrument used to demonstrate the efficacy of each program. The instrument can be re-used as is, or modified for use in a new evaluation in a new setting. The Sociometrics Library also offers additional, generic resources for program evaluation. The family of evaluation instruments and resources supporting each effective program facilitates re-evaluation in a new setting, to test the robustness of the initial finding of efficaciousness in the original site and to improve future implementations in the local site.

7) Scalable design. The Sociometrics Library was built with both scalable design and a technological infrastructure for ease of future expansion, as other effective programs, datasets, and capacity-building tools are identified. The innovative technological platform allows for the upload and distribution of a wide variety of product and file types, including increasingly common multimedia products.

5. Conclusion

The Sociometrics Social, Behavioral, and Health Sciences Library at https://www.socio.com/ is a rich and innovative source of exemplary HIV/AIDS evidence-based programs (EBPs), datasets, and capacity-building tools for the continued professional education of HIV professionals. With several new innovations in prevention programming―such as low cost 24/7 access to all facilitator, student, and evaluation materials comprising a diverse set of effective HIV/AIDS prevention programs; and “responsive design” for use on computers, tablets, and smartphones―the Sociometrics Library facilitates research as well as EBP uptake, implementation, and evaluation across a range of settings, including schools, clinics, community-based organizations, universities, global settings, low-resource settings, and settings with specific minority populations that have shouldered the brunt of the HIV epidemic.

NOTES

#The Sociometrics Social, Behavioral, and Health Sciences Library was developed with funding from the US National Institute of Minority Health and Health Disparities of the US National Institutes of Health (Grant No. R44 MD08851-02A1, Josefina J. Card, PhD, Principal Investigator). The authors are grateful to Drs. Anya Drabkin and Julie Solomon for their review of earlier drafts of this manuscript.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Card, J. and Baden, L. (2018) An Online Library of Science-Based HIV Prevention Resources. World Journal of AIDS, 8, 119-136. doi: 10.4236/wja.2018.84010.

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