The aim of this study was to develop and test a cost-effective, scalable HIV behavioral intervention for African American women. Eighty-three African American women were recruited from a community health center and randomly assigned to either the web-based Safe Sistah program or to a delayed HIV education control condition. The primary outcome was self-reported condom use. Secondary measures assessed other aspects of the gender-focused training included in Safe Sistah. Participants completed self-report assessments prior to randomization, 1- and 4-months after their program experience. Across the entire study period, women in the experimental condition significantly increased their condom use relative to controls (F = 5.126, p = 0.027). Significant effects were also found for sexual communication, sex refusal, condom use after alcohol consumption, and HIV prevention knowledge. These findings indicate that this web-based program could be an important component in reducing the HIV disparities among African American women.

We evaluated the effectiveness of a web-based version of the Life-Steps intervention combined with modules for stress reduction and mood management, designed to improve medication adherence among HIV infected individuals. 168 HIV+ adults were randomized into either the Life-Steps program or a waitlist control condition. All participants completed a baseline assessment and provided a 2-week electronic pill (MEMS) cap baseline reading. Follow up data collection was conducted at 3, 6 and 9 months. Patients in the web-based Life-Steps condition had significantly higher antiretroviral medication adherence rates than patients in the control group over the nine-month period as measured by the MEMS cap. In addition, analysis of viral load data indicated that the program also resulted in a significant decrease in viral load. These findings indicate that a web-based Life-Steps program can be a useful and implementable tool for helping patients living with HIV maintain medication adherence.

For adolescents to become independent in Type 1 diabetes self-management, they must develop capability through experiential learning. It is important that parents and health professionals understand the important role they play in this process and have the skills to support adolescents in this way. Data from this study have been used to develop an online interactive 'Adolescent Diabetes Needs Assessment Tool', which assesses individual learning and support needs to aid the process of feedback and discussion.

Spencer J, Cooper H, Milton B. Qualitative studies of type 1 diabetes in adolescence: a systematic literature review.

Aim To report on the development and psychometric testing of the Adolescent Diabetes Needs Assessment Tool. Background The UK has the fifth largest paediatric diabetes population in the world, but one of the poorest levels of diabetes control, highlighting the need for intervention development. Design Mixed methods following recommendations for questionnaire design and validation. Methods A total of 171 young people (12–18 years) participated between 2008– 2011. Methods included item selection using secondary framework analysis, item review, pre‐testing, piloting and online transfer. Statistical tests assessed reliability using item‐total correlations, interitem consistency and test–retest reliability; and validity using blood glucose (HbA1c) levels and the Self‐Management of type 1 Diabetes in Adolescence questionnaire. Results The Adolescent Diabetes Needs Assessment Tool consists of 117 questions divided between six domains of educational and psychosocial support needs. It combines reflective questioning with needs assessment to raise self‐awareness to support adolescent decision‐making in relation to diabetes self‐care. Thirty‐six of the questions provide self‐care and psychosocial health assessment scores. Face and content validity of the scoring items were all positively evaluated in terms of appropriateness and readability and tests for validity found significant correlations with Self‐Management of type 1 Diabetes in Adolescence and weak correlation with HbA1c, which compared favourably with Self‐Management of type 1 Diabetes in Adolescence, the only comparable (USA) tool. Item response analysis validated the use of simple additive scores. Conclusions The Adolescent Diabetes Needs Assessment Tool combines reflective learning with needs assessment to support patient‐centred clinical consultations.