Pilot randomized trial of education to improve self-management skills of men with symptomatic HIV/AIDS
Abstract
OBJECTIVE: To evaluate the acceptability, practicality, and short-term efficacy of a health education program to improve disease self-management in patients with symptomatic HIV/AIDS. DESIGN: Randomized controlled trial, baseline and 3-month follow-up questionnaire assessments. SETTING: San Francisco Bay communities. PARTICIPANTS: Seventy-one men with symptomatic HIV or AIDS were randomly assigned to a seven-session group educational intervention (N=34) or a usual-care control group (N=37). INTERVENTION: Interactive health education groups were used to teach wide-ranging disease self-management skills and information: symptom assessment and management, medication use, physical exercise, relaxation, doctor-patient communication, and nutrition. Each group was led by two trained peer-leaders (one of whom was HIV-positive) recruited from the community. MAIN OUTCOME MEASURES: The primary outcome of interest was symptom status. Secondary outcomes were self-efficacy and health behaviors. Analysis of covariance was used to compare experimental and control group mean outcomes, adjusting for baseline value differences. RESULTS: The symptom severity index (number of symptoms moderate or greater severity) decreased in the experimental, and increased in the control group (-0.9 versus +0.5; p < .03). Pain, fatigue, and psychological symptoms were not significantly different between groups. Self-efficacy for controlling symptoms improved in the experimental, and decreased in the control group (+4 versus -7; p < .02). Changes in stress/relaxation exercises and HIV/AIDS knowledge were not different between groups. A trend was shown toward more frequent physical exercise in the experimental group compared with less in the control group (+1.3 versus -0.5 times/week; p=.06). CONCLUSIONS: Health education emphasizing self-management skills for HIV/AIDS patients can be implemented and evaluated and was accepted by patients, peer-leaders, and health care providers. Whether this educational program can lead to prolonged improvement in HIV symptoms and behaviors can be adequately addressed only by a larger trial of longer duration.
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Parents of children with ADHD are reported to view medication as less socially acceptable than psychosocial or combined interventions.
“parents of children with ADHD are reported to consider medication treatments less socially acceptable than psychosocial or combination interventions.40”
From Medication Adherence in the MTA: Saliva Methylphenidate Samples Versus Parent Report and Mediating Effect of Concomitant Behavioral Treatment (2009) · cites this paper as [40]
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Self-citation
- Authors
- Gifford, A. L., Laurent, D. D., Gonzales, V. M., Chesney, M. A., & Lorig, K. R.
- Affiliations
- University of California San Diego (US)
- Stanford Medicine (US)
- University of California, San Francisco (US)
- Corresponding author
- Gifford, Allen L.
- Venue
- Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
- Published
- 1998-06
- Volume
- 18
- Issue
- 2
- Pages
- 136-144
- ISSN
- 1077-9450 (ISSN-L)
- OpenAlex
- W1989705629
- Cited by
- 132
- References
- 32
- Citations by year
- 2026: 2 · 2023: 1 · 2022: 2 · 2021: 4 · 2019: 5 · 2018: 7 · 2017: 7 · 2016: 5 · 2015: 7 · 2014: 7 · 2013: 13 · 2012: 6
- FWCI
- 3.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Acquired Immune Deficiency Syndromes & Human Retrovirology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- HIV/AIDS, symptomatic HIV, disease self-management, health education, group educational intervention, peer leaders, symptom management, self-efficacy, physical activity, stress and relaxation, physician-patient communication, nutrition, medication use, HIV-positive men, San Francisco Bay Area
- MeSH terms
- Acquired Immunodeficiency Syndrome, California, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Patient Education as Topic, Physician-Patient Relations, Pilot Projects, Surveys and Questionnaires, Self Care, Severity of Illness Index, Health Behavior, HIV Infections
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