Experiences with a violence and mental health safety protocol for a randomized controlled trial to support youth living with HIV

作     者：Katherine G.Merrill Jonathan K.Mwansa Sam Miti Virginia M.Burke Elizabeth A.Abrams Christiana Frimpong Michele R.Decker Jacquelyn C.Campbell Julie A.Denison 

作者机构：Department of International HealthJohns Hopkins Bloomberg School of Public Health615 N.Wolfe StreetBaltimoreMD 21205USA Arthur Davison Children’s HospitalNdolaZambia Department of PopulationFamily and Reproductive HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA Department of Community-Public HealthJohns Hopkins School of NursingBaltimoreMDUSA Present Address:Department of MedicineUniversity of Illinois at ChicagoChicagoILUSA 

出 版 物：《Global Health Research and Policy》 (全球健康研究与政策（英文）)

年 卷 期：2021年第6卷第1期

页      面：87-96页

学科分类：08[工学] 080502[工学-材料学] 0805[工学-材料科学与工程（可授工学、理学学位）] 

基　　金：provided by Project SOAR,a six-year cooperative agreement funded by the U.S.President’s Emergency Plan for AIDS Relief(PEPFAR) the U.S.Agency for International Development(USAID,Agreement No.AID-OAA-A-14-00060) the Johns Hopkins Center for AIDS Research(P30AI094189) supported by the National Institute of Mental Health of the National Institutes of Health under Award Number F31MH116821-01A1 

主　　题：Safety protocol Referral Violence Mental health HIV Youth Zambia 

摘      要：Background:Safety protocols are an essential component of studies addressing violence and mental health but are rarely described in the published literature from Sub-Saharan *** designed and implemented a safety protocol within Project YES!(Youth Engaging for Success),which enrolled 276 youth living with HIV(ages 15–24 years)in a randomized controlled trial of a peer-mentoring intervention across four HIV clinics in Ndola,***:Youth who reported severe violence and/or suicidal thoughts on research surveys or during meetings with youth peer mentors(YPM)were referred to designated healthcare providers(HCP).We explored experiences with the safety protocol using:a)monitoring data of referrals,and b)in-depth interviews with youth(n=82),HCP(n=10),YPM(n=8),and staff(n=6).Descriptive statistics were generated and thematic analysis of coded transcripts and written memos ***:Nearly half of youth enrolled(48%of females,41%of males)were referred to a HCP at least *** first referral was most often for sexual violence(35%)and/or suicidal ideation/depression(29%).All referred youth aged 15–17 years and over 80%of referred youth aged 18+agreed to see a *** referred 15%for additional services outside the ***-nine youth,all HCP,all YPM,and all staff interviewed discussed the safety *** youth felt“encouraged,“helped,“unburdened,and“relievedby their meetings with HCP;some expressed concerns about meeting with *** safety protocol helped HCP recognize the need to integrate care for violence and mental health with medication adherence ***,YPM,and study staff raised implementation challenges,including youth choosing not to open up to HCP,time and resource constraints,deficiencies in HCP training,and stigma and cultural norms inhibiting referrals outside the clinic for emotional trauma and mental ***:Implementing a safety protocol within an HIV clinic-based research study is possible and beneficial for