Research Centers & Affiliations
IUHR - Prevention and Access to Care and Treatment Project (PACT)
Prevention and Access to Care and Treatment Project
The Prevention and Access to Care and Treatment (PACT) Project provides community-based HIV education services for HIV-positive men and women. Adults in the greater Boston area may enroll or be referred to take part in the PACT Project through Brigham and Women's Hospital who are 1.) HIV-positive, 2.) in need of medical care and 3.) wish to receive HIV education sessions from a Community Health Worker (CHW). The PACT Project uses a community-based intervention model to provide integrated services led primarily by health promoters affiliated with Brigham and Women's Hospital. In addition to the Community Health Workers, the project utilizes a network of service agencies from a wide range health care, mental health, and social service providers in the community.
The purpose of the PACT Project study is to provide harm reduction training, materials, and prevention case management to high-risk HIV-positive individuals. Fifteen HIV-positive patients who are currently enrolled in the Prevention and Access to Care and Treatment Project (PACT) Program at Brigham and Women's Hospital will be recruited to participate in the pre-pilot study in order to provide in-depth information on the adequacy of the intervention content, adequacy of the intervention delivery (fidelity) and patient understanding of the intervention content, and satisfaction with the intervention in this medications adherence education intervention. The goal of the current research is to create an educational intervention to increase medication adherence among HIV-positive patients. Following the pre-pilot and pilot phases of the study, the HIV education curriculum will be thoroughly reviewed based on the qualitative and quantitative data gathered. Modifications to the education curriculum will be made in accordance with the results and feedback from the research team, community health workers, and patients.
To date, 5 PACT clients have been enrolled in the pre-pilot phase of the study. Participants are referred to the study by their CHW. Participants complete a total of 6 education sessions, or modules, with their CHW at the PACT offices in Dorchester, MA. The research team assesses the patient's prior knowledge of the education material using a brief multiple-choice pre-test. Following the pre-test, a video camera is used to record the Community Health Worker delivering the health education session to the patient. Immediately following the education session, the research team delivers a post-test, cognitive interview, and satisfaction survey that are given to the patient to assess his/her knowledge and understanding of the session and also to document any patient feedback/input regarding the education session. Six months following enrollment, the patient and his/her CHW will conduct an additional education session at the PACT Offices under the same conditions and study procedures.
The preliminary analyses of data gathered from the 5 men and women currently participating in the pre-pilot phase of the study suggest that they demonstrate a general understanding of the HIV education curriculum. The patients typically improve from their pre-test score after the health session is delivered. In addition, the feedback the patient does provide about the PACT Program, their CHW and their participation in the study is positive. After viewing approximately 20 education sessions of the Community Health Workers delivering the intervention, it appears that the educational graphics and tools embedded within the PACT curriculum are useful and accessible by both the patient and CHW. This data has been presented at three different working retreats with the community advisory team that is working to refine the curriculum. In addition, preliminary video evaluation tools for rating CHW delivery were designed in April 2008. These tools are currently undergoing a revision process with the hopes of being implemented for the pilot phase of the study in November.
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