The Impact of a Situationally Focused Individual Human Immunodeficiency Virus/Sexually Transmitted Disease Risk-Reduction Intervention on Risk Behavior in a 1-Year Cohort of Nigerian Military Personnel

Ross, Michael W.; Essien, E. James; Ekong, Ernest; James, Tiffeny; Amos, Charles; Ogungbade, Gbadebo; Williams, Mark L.

doi:10.7205/milmed.171.10.970

Cited by 12 publications

(11 citation statements)

References 6 publications

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“…Some studies also considered completeness of intervention delivery, where the number of intervention components delivered was considered as a proportion of those planned (e.g. [23, 31, 36]). One school-based study called this ‘fidelity to classroom dose’ and while time spent on each activity was also measured, it was referred to as ‘duration’, not dose [37].…”

Section: Resultsmentioning

confidence: 99%

Variation in the operationalisation of dose in implementation of health promotion interventions: insights and recommendations from a scoping review

2019

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Background While ‘dose’ is broadly understood as the ‘amount’ of an intervention, there is considerable variation in how this concept is defined. How we conceptualise, and subsequently measure, the dose of interventions has important implications for understanding how interventions produce their effects and are subsequently resourced and scaled up. This paper aims to explore the degree to which dose is currently understood as a distinct and well-defined implementation concept outside of clinical settings. Methods We searched four databases (MEDLINE, PsycINFO, EBM Reviews and Global Health) to identify original research articles published between 2000 and 2015 on health promotion interventions that contained the word ‘dose’ or ‘dosage’ in the title, abstract or keywords. We identified 130 articles meeting inclusion criteria and extracted data on how dose/dosage was defined and operationalised, which we then synthesised to reveal key themes in the use of this concept across health promotion interventions. Results Dose was defined in a variety of ways, including in relation to the amount of intervention delivered and/or received, the level of participation in the intervention and, in some instances, the quality of intervention delivery. We also observed some conflation of concepts that are traditionally kept separate (such as fidelity) either as slippage or as part of composite measures (such as ‘intervention dose’). Discussion Dose is not a well-defined or consistently applied concept in evaluations of health promotion interventions. While current approaches to conceptualisation and measurement of dose are suitable for interventions in organisational settings, they are less well suited to policies delivered at a population level. Dose often accompanies a traditional monotonic linear view of causality (e.g. dose response) which may or may not fully represent the intervention’s theory of how change is brought about. Finally, we found dose and dosage to be used interchangeably. We recommend a distinction between these terms, with ‘dosage’ having the advantage of capturing change to amount ‘dispensed’ over time (in response to effects achieved). Dosage therefore acknowledges the inevitable dynamic and complexity of implementation. Electronic supplementary material The online version of this article (10.1186/s13012-019-0899-x) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Variation in the operationalisation of dose in implementation of health promotion interventions: insights and recommendations from a scoping review

2019

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“…Irrespective of an underlying causal mechanism, our results indicate that soldiers suffering from both PTSD and depression should be the focus of future HIV prevention efforts. Although militaryfocused HIV prevention interventions have been implemented and are effective at reducing risk behavior in some settings (Bing et al, 2008;Ross et al, 2006;Russak, Ortiz, Galvan, & Bing, 2005), to our knowledge no studies have evaluated the efficacy of HIV prevention programs specifically for military personnel with mental illness. Given the significant burden of mental health problems in this population (Kehle et al, 2011;Milliken, Auchterlonie, & Hoge, 2007;Thomas et al, 2010), interventions that integrate psychiatric and HIV prevention services warrant development and evaluation.…”

Section: Discussionmentioning

confidence: 99%

Posttraumatic Stress Disorder, Depression, and HIV Risk Behavior Among Ohio Army National Guard Soldiers

Marshall

Prescott

Liberzon

et al. 2013

Journal of Traumatic Stress

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We examined the relationship between posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and human immunodeficiency virus (HIV) risk behavior among the Ohio Army National Guard (OHARNG). We analyzed data collected from a sample of OHARNG enlisted between June 2008 and February 2009. Participants completed interviews assessing HIV risk activities defined by the Behavioral Risk Factor Surveillance System, and were screened for PTSD and MDD based on DSM-IV criteria according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV; American Psychiatric Association, 1994). Logistic regression was used to examine the independent and combined effects of PTSD and MDD on past-year HIV risk behavior. Of 2,259 participants, 142 (6.3%) reported at least 1 past-year HIV risk behavior. In adjusted models, relative to soldiers with neither disorder, screening positive for MDD only was associated with HIV risk behavior (adjusted odds ratio [AOR] = 2.33, 95% CI = [1.15, 4.71]), whereas PTSD was not significant (AOR = 1.60, 95% CI = [0.80, 3.20]). Participants with both PTSD and depression were most likely to report HIV risk behavior (AOR = 2.75, 95% CI = [1.06, 7.11]). Soldiers with PTSD and MDD may be at greater risk for HIV infection due to increased engagement in HIV risk behavior. Integrated interventions to address mental health problems and reduce HIV risk behavior are in need of development and evaluation.

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“…At six months, risk behavior reporting decreased by 30% and by 23% at 12 months. Report of condom use increased significantly at both time points as well in comparison to baseline [22]. …”

Section: Introductionmentioning

confidence: 99%

HIV/AIDS, conflict and security in Africa: rethinking relationships

Becker

Theodosis

Kulkarni

2008

Journal of the International AIDS Society

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The effect of conflict on HIV transmission and regional and global security has been the subject of much recent discussion and debate. Many long held assumptions regarding these relationships are being reconsidered. Conflict has long been assumed to contribute significantly to the spread of HIV infection. However, new research is casting doubt on this assumption. Studies from Africa suggest that conflict does not necessarily predispose to HIV transmission and indeed, there is evidence to suggest that recovery in the "post-conflict" state is potentially dangerous from the standpoint of HIV transmission. As well, refugee populations have been previously considered as highly infected vectors of HIV transmission. But in light of new investigation this belief is also being reconsidered. There has additionally been concern that high rates of HIV infection among many of the militaries of sub-Saharan Africa poses a threat to regional security. However, data is lacking on both dramatically elevated prevalence amongst soldiers and a possible negative effect on regional security. Nevertheless, HIV/AIDS remain a serious threat to population health and economic well being in this region. These issues are of vital importance for HIV programming and health sector development in conflict and "post-conflict" societies and will constitute formidable challenges to the international community. Further research is required to better inform the discussion of HIV, conflict, and security in sub-Saharan Africa.

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The Impact of a Situationally Focused Individual Human Immunodeficiency Virus/Sexually Transmitted Disease Risk-Reduction Intervention on Risk Behavior in a 1-Year Cohort of Nigerian Military Personnel

Cited by 12 publications

References 6 publications

Variation in the operationalisation of dose in implementation of health promotion interventions: insights and recommendations from a scoping review

Variation in the operationalisation of dose in implementation of health promotion interventions: insights and recommendations from a scoping review

Posttraumatic Stress Disorder, Depression, and HIV Risk Behavior Among Ohio Army National Guard Soldiers

HIV/AIDS, conflict and security in Africa: rethinking relationships

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