Through December 2003, more than 55,300 persons were living in small towns and rural areas of the United States at the time of their AIDS diagnosis. Many HIV-infected rural persons experience elevated levels of depression, suicidal ideation, and anxiety. This research tested if two telephone-delivered, mental health interventions could facilitate the adjustment efforts of persons living with HIV/AIDS in rural areas of the United States. Participants (N=299) were recruited through AIDS service organizations in 13 states and assigned to a Usual Care Condition (n=107), an 8-session Information Support Group Intervention (n=84), or an 8-session Coping Improvement Group Intervention (n=108). Participants completed self-administered surveys at pre-intervention, post-intervention, and 4- and 8-month follow-ups. ANCOVA revealed that no treatment condition produced reductions in the main outcome measures of depressive and psychological symptoms; however, Information Support participants received significantly more support from friends at 4- and 8-month follow-ups and reported fewer barriers to health care and social services at 4-month follow-up compared to participants in the other two conditions. Telephone-delivered, information-support groups have potential to increase perceptions of support and reduce barriers to health care and social services in this population, but the practical significance of these intervention-related changes is limited.
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REFERENCES
Beck, A. T., & Steer, R. A. (1993). In BDI: beck depression inventory manual. New York: Psychological Corporation.
Cella, D. F., McCain, N. L., Peterman, A. H., Mo, F., & Wolen, D. (1996). Development and validation of the Functional Assessment of Human Immunodeficiency Virus Infection (FAHI) quality of life instrument. Quality of Life Research, 5, 450–463.
Centers for Disease Control and Prevention (2004). HIV/AIDS Surveillance Report,2003 (Vol. 15). Atlanta: US Department of Health and Human Services, Centers for Disease Control and Prevention. 15: 30.
Cherry, R., & Rubinstein, A. (1995). The long-term effect of early telephone intervention on hearing aid success. Scandanavian Audiology, 24, 243–246.
Chesney, M., Folkman, S., & Chambers, D. (1996). Coping effectiveness training for men living with HIV: Preliminary findings. International Journal of STD & AIDS, (Suppl. 2), S75–S82.
Crane, L. A., Leakey, B. A., Rimer, B. K., Wolfe, P., Woodworth, M. A., & Warnecke, R. B. (1998). Effectiveness of telephone outcall intervention to promote screening mammography among low-income women. Preventive Medicine, 27, S39–S49.
Derogatis, L. R. (1983). In SCL-90-R, administration, scoring and procedures manual-II. Towson, MD: Clinical Psychometric Research.
Evans, R. L., Halar, E. M., & Smith, K. M. (1985). Cognitive therapy to achieve personal goals: Results of telephone group counseling with disabled adults. Archives of Physical and Medical Rehabilitation, 66, 693–696.
Folkman, S., Chesney, M., McKusick, L., Ironson, G., Johnson, D. S., & Coates, T. J. (1991). Translating coping theory into intervention. In J. Eckenrode (Ed.), The social context of coping (pp. 239–259). New York: Plenum.
Friedman, R. H., Kazis, L. E., Jette, A., Smith, M. B., Stollerman, J. E., Torgerson, J., et al. (1996). A telecommunications system for monitoring and counseling patients with hypertension: Impact on medication adherence and blood pressure control. American Journal of Hypertension, 9, 285–292.
Greineder, D. K., Loane, K. C., & Parks, P. (1995). Reduction in resource utilization by an asthma outreach program. Archives of Pediatric and Adolescent Medicine, 149, 415–420.
Glueckauf, R. L., & Ketterson, T. U. (2004). Telehealth interventions for individuals with chronic illness: Research review and implications for practice. Professional Psychology: Research and Practice, 35, 615–627.
Heckman, T. G., Somlai, A. M., Kalichman, S. C., Franzoi, S., & Kelly, J. A. (1998). Psychosocial differences between urban and rural people living with HIV/AIDS. Journal of Rural Health, 14, 138–145.
Heckman, T. G., Somlai, A. M., Otto−Salaj, L., Peters, J., Walker, J., Galdabini, C. A., & Kelly J. A. (1998). Barriers to care among persons living with HIV/AIDS in urban and rural areas. AIDS Care, 10, 365–75.
Heckman, T. G., Miller, J. G., Kochman, A., Kalichman, S. C., Carlson, B., & Silverthorn, M. (2002). Thoughts of suicide among HIV-infected rural persons enrolled in a telephone-delivered mental health intervention. Annals of Behavioral Medicine, 24, 141–148.
Heckman, T. G., Anderson, E., Sikkema, K. J., Kochman, A., Kalichman, S. C., & Anderson, T. (2004). Depressive symptoms in non-metropolitan persons living with HIV disease enrolled in a telephone-delivered mental health intervention. Health Psychology, 23, 94–100.
Kelly, J. A., Murphy, D. A., Bahr, G. R., Kalichman, S. C., Morgan, M. G., Stevenson, L. Y., et al. (1993). Outcome of cognitive-behavioral and support group brief therapies for depressed, HIV-infected persons. American Journal of Psychiatry, 150, 1679–1686.
Lazarus, R. S., & Folkman, S. (1984). In Stress, appraisal, and coping. New York, NY: Springer Publishing Company.
Lerman, C., Hanjani, P., Caputo, C., Miller, S., Delmoor, E., Nolte, S., et al. (1992). Telephone counseling improves adherence to colposcopy among lower-income minority women. Journal of Clinical Oncology, 10, 330–333.
Martin, D. J., Riopelle, D., Steckart, M. J., Geshke, N., & Lin, S. (2001). Support group participation, HIV viral load, and sexual risk behavior. American Journal of Health Behavior, 25, 513–527.
McBride, C. M., & Rimer, B. K. (1999). Using the telephone to improve health behavior and health service delivery. Patient Education and Counseling, 37, 3–18.
Mohr, D. C., Likosky, W., Bertagnolli, A., Goodkin, D. E., Van Der Wende, J., & Dwyer, P., et al. (2000). Telephone-administered cognitive-behavioral therapy for the treatment of depressive symptoms in multiple sclerosis. Journal of Counseling and Clinical Psychology, 68, 356–362.
Monnier, J., Knapp, R. G., & Frueh, B. C. (2003). Recent advances in telepsychiatry: An updated review. Psychiatric Services, 54, 1604–1609.
Paykel, E. S., Abbott, R., Jenkins, R., Brugha, T. S., & Meltzer, H. (2000). Urban-rural differences in Great Britain: Findings from the National Morbidity Study. Psychological Medicine, 30, 269–280.
Sandgren, A. K., & McCaul, K. D. (2003). Short-term effects of telephone therapy for breast cancer patients. Health Psychology, 22, 310–315.
Sikkema, K. J., Kalichman, S. C., Hoffmann, R., Koob, J. J., Kelly, J. A., & Heckman, T. G. (2000). Coping strategies and emotional well-being among HIV-infected men and women experiencing AIDS-related bereavement. AIDS Care, 12, 613–624.
Stoddard, A. M., Fox, S. A., Costanza, M. E., Lane, D. S., Anderson, A. R., Urban, N., et al. (2002). Effectiveness of telephone counseling for mammography: Results from five randomized trials. Preventive Medicine, 34, 90–99.
Turner, R. J., Frankel, B. G., & Levin, D. M. (1983). Social support: Conceptualization, measurement, and implications for mental health. Research in Community and Mental Health, 3, 67–111.
Ullrich, P. M., Lutgendorf, S. K., & Stapleton, J. T. (2002). Social constraints and depression in HIV-infection: Effects of sexual orientation and area of residence. Journal of Clinical and Social Psychology, 21, 46–66.
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This research was supported by a grant from the National Institute of Mental Health (RO1 MH59009). We acknowledge Seth Hilhoch, M.D., M.P.H., for his editorial assistance.
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Heckman, T.G., Carlson, B. A Randomized Clinical Trial of Two Telephone-Delivered, Mental Health Interventions for HIV-Infected Persons in Rural Areas of the United States. AIDS Behav 11, 5–14 (2007). https://doi.org/10.1007/s10461-006-9111-9
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DOI: https://doi.org/10.1007/s10461-006-9111-9