Abstract
We propose a set of common factors in evidence-based interventions (EBI) for HIV prevention, which cut across theoretical models of behavior change. Three existing literatures support this agenda: (1) Common factors in psychotherapy; (2) core elements from the Centers for Disease Control and Prevention EBIs; and (3) component analyses of EBI. To stimulate discussion among prevention researchers, we propose a set of common factors at the highest level of abstraction that describe what all effective programs do: (1) establish a framework to understand behavior change; (2) convey issue-specific and population-specific information necessary for healthy actions; (3) build cognitive, affective, and behavioral self-management skills; (4) address environmental barriers to implementing health behaviors; and (5) provide tools to develop ongoing social and community support for healthy actions. A focus on common factors will enhance research on new HIV prevention interventions, encourage collaboration among researchers, provide guidelines for adapting EBI, and simplify and speed the adoption of EBI for providers.
Similar content being viewed by others
Notes
Lambert and Bergin (1994) use an analogous set of arguments to explain the importance of common factors in psychotherapy.
References
Albarracin, D., Gillette, J. C., Earl, A. N., Glasman, L. R., Durantini, M. R., & Ho, M.-H. (2005). A test of major assumptions about behavior change: A comprehensive look at the effects of passive and active HIV-prevention interventions since the beginning of the epidemic. Psychological Bulletin, 131(6), 856–897. doi:10.1037/0033-2909.131.6.856.
Albarracin, D., McNatt, P. S., Klein, C. T. F., Ho, R. M., Mitchell, A. L., & Kumkale, G. T. (2003). Persuasive communications to change actions: An analysis of behavioral and cognitive impact in HIV prevention. Health Psychology, 22(2), 166–177.
Bickman, L. (2005). A common factors approach to improving mental health services. Mental Health Services Research, 7(1), 1–4. doi:10.1007/s11020-005-1961-7.
Centers for Disease Control and Prevention. (2001). REP packages. Retrieved March 13, 2007. http://www.cdc.gov/hiv/projects/rep/search.htm.
Chorpita, B. F., Becker, K. D., & Daleiden, E. L. (2007). Understanding the common elements of evidence-based practice: Misconceptions and clinical examples. Journal of the American Academy of Child and Adolescent Psychiatry, 46(5), 647–652. doi:10.1097/chi.0b013e318033ff71.
Chorpita, B. F., Daleiden, E. L., & Weisz, J. R. (2005). Identifying and selecting the common elements of evidence based interventions: A distillation and matching model. Mental Health Services Research, 7(1), 5–20. doi:10.1007/s11020-005-1962-6.
Collins, C., Harshbarger, C., Sawyer, R., & Hamdallah, M. (2006). The diffusion of effective behavioral interventions project: Development, implementation, lessons learned. AIDS Education and Prevention, 18, 5–20. doi:10.1521/aeap.2006.18.supp.5.
Duan, N., & Rotheram-Borus, M. J. (1999). Development and dissemination of successful behavioral prevention interventions: Safety, innovation, essential ingredients, robustness, and marketability. In Translating prevention research into social work practice (monograph). Seattle: University of Washington, School of Social Work, Prevention Research Center.
Dworkin, S. L., Pinto, R. M., Hunter, J., Rapkin, B., & Remien, R. H. (2008). Keeping the spirit of community partnerships alive in the scale up of HIV/AIDS prevention: Critical reflections on the roll out of DEBI (diffusion of effective behavioral interventions). American Journal of Community Psychology, 42(1–2), 51–59.
Eke, A. N., Mezoff, J. S., Duncan, T., & Sogolow, E. D. (2006). Reputationally strong HIV prevention programs: Lessons from the front line. AIDS Education and Prevention, 18(2), 163–175. doi:10.1521/aeap.2006.18.2.163.
Fishbein, M., von Haeften, I., & Appleyard, J. (2001). The role of theory in developing effective interventions: Implications from project SAFER. Psychology Health and Medicine, 6(2), 223–238.
Fisher, J. D., & Fisher, W. A. (1992). Changing AIDS-risk behavior. Psychological Bulletin, 111(3), 455–474. doi:10.1037/0033-2909.111.3.455.
Frank, J. D. (1961). Persuasion and healing. Baltimore: Johns Hopkins.
Garfield, S. L. (1991). Common and specific factors in psychotherapy. Journal of Integrative and Eclectic Psychotherapy, 10, 5–13.
Garland, A. F., Hawley, K. M., Brookman-Frazee, L. B., & Hurlburt, M. S. (2008). Identifying common elements of evidence-based psychosocial treatments for children’s disruptive behavior problems. Journal of the American Academy of Child and Adolescent Psychiatry, 47(5), 505–514. doi:10.1097/CHI.0b013e31816765c2.
Green, L. W. (2006). Public health asks of systems science: To advance our evidence-based practice, can you help us get more practice based evidence? American Journal of Public Health, 96(3), 406–409. doi:10.2105/AJPH.2005.066035.
Ingram, B. L., Flannery, D., Elkavich, A., & Rotheram-Borus, M. J. (2008). Common processes in evidence-based adolescent HIV prevention programs. AIDS and Behavior, 12(3), 374–383. doi:10.1007/s10461-008-9369-1.
Jemmott, J. B., Jemmott, L. S., & Fong, G. T. (1992). Reductions in HIV risk-associated sexual behaviors among black male adolescents: Effects of an AIDS prevention intervention. American Journal of Public Health, 82(3), 372–377.
Jensen, P. S. (2003). Commentary: The next generation is overdue. Journal of the American Academy of Child and Adolescent Psychiatry, 42(5), 527–530. doi:10.1097/01.CHI.0000046837.90931.A0.
Kalichman, S. C., Cain, D., Weinhardt, L., Benotsch, E., Presser, K., Zweben, A., et al. (2005). Experimental components analysis of brief theory-based HIV/AIDS risk-reduction counseling for sexually transmitted infection patients. Health Psychology, 24(2), 198–208. doi:10.1037/0278-6133.24.2.198.
Kalichman, S. C., Picciano, J. F., & Roffman, R. A. (2008). Motivation to reduce HIV risk behaviors in the context of the information, motivation and behavioral skills (IMB) model of HIV prevention. Journal of Health Psychology, 13(5), 680–689. doi:10.1177/1359105307082456.
Kalichman, S.·C., Rompa, D., & Coley, B. (1996). Experimental component analysis of a behavioral HIV-AIDS prevention intervention for inner-city women. Journal of Consulting and Clinical Psychology, 64(4), 687–693. doi:10.1037/0022-006X.64.4.687.
Kaminski, J. W., Valle, L. A., Filene, J. H., & Boyle, C. L. (2008). A meta-analytic review of components associated with parent training program effectiveness. Journal of Abnormal Child Psychology, 36, 567–589. doi:10.1007/s10802-007-9201-9.
Kegeles, S. M., Rebchook, G. M., Hays, R. B., terry, M. A., O’Donnell, L., Leonard, N. R., et al. (2000). From science to application: The development of an intervention package. AIDS Education and Prevention, 12(Suppl. A), 62–74.
Kelly, J. A., Heckman, T. G., Stevenson, L. Y., Williams, P. N., Ertl, T., Hays, R. B., et al. (2000). Transfer of research-based HIV prevention interventions to community service providers fidelity and adaptation. AIDS Education and Prevention, 12(Suppl A), 87–98.
Kelly, J. A., Murphy, D. A., Sikkema, K. J., McAuliffe, R. L., Roffman, R. A., Solomon, L. J., et al. (1997). Randomized, controlled, community-level HIV-prevention intervention for sexual-risk behaviour among homosexual men in US cities. Community HIV prevention research collaborative. Lancet, 350, 1500–1505. doi:10.1016/S0140-6736(97)07439-4.
Kelly, J. A., Spielberg, F., & McAuliffe, T. L. (2008). Defining, designing, implementing, and evaluating phase 4 HIV prevention effectiveness trials for vulnerable populations. Journal of Acquired Immune Deficiency Syndromes, 47(Supp 1), S28–S33. doi:10.1097/QAI.0b013e3181605c77.
Kelly, J. A., St. Lawrence, J. S., Stevenson, L. Y., Hauth, A. C., Kalichman, S. C., Diaz, Y. E., et al. (1992). Community AIDS/HIV risk reduction: The effects of endorsements by popular people in three cities. American Journal of Public Health, 82(11), 1483–1489.
Knowlton, A., Hua, W., & Latkin, C. (2004). Social support among HIV positive injection drug users: Implications to integrated intervention for HIV positives. AIDS and Behavior, 8(4), 357–363. doi:10.1007/s10461-004-7320-7.
Lambert, M. J., & Bergin, A. E. (1994). The effectiveness of psychotherapy. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (4th ed., pp. 143–189). New York: John Wiley and Sons, Inc.
Lampropoulos, G. K. (2001). Common processes of change in psychotherapy and seven other social interactions. British Journal of Guidance & Counselling, 29(1), 21–33. doi:10.1080/03069880020019356.
Lauby, J. L., Smith, P. J., Stark, M., Person, B., & Adams, J. (2000). A community-level HIV prevention intervention for inner city women: Results of the women and infants demonstration projects. American Journal of Public Health, 90(2), 216–222.
Lyles, C. M., Kay, L. S., Crepaz, N., Herbst, J. M., Passin, W. F., Kim, A. S., et al. (2007). Best-evidence interventions: Findings from a systematic review of HIV behavioral interventions for U.S. populations at high risk, 2000–2004. American Journal of Public Health, 97(1), 133–143. doi:10.2105/AJPH.2005.076182.
Marlatt, G. A., & George, W. H. (1998). Relapse prevention and the maintenance of optimal health. In S. A. Shumaker, E. B. Schron, et al. (Eds.), The handbook of health behavior change (2nd ed., pp. 33–58). New York: Springer.
McKleroy, V. S., Galbraith, J. S., Cummings, B., Jones, P., Harshbarger, C., Collins, C., et al. (2006). Adapting evidence-based behavioral interventions for new settings and target populations. AIDS Education and Prevention, 18(Suppl A), 59–73. doi:10.1521/aeap.2006.18.supp.59.
Messer, S. B., & Wampold, B. E. (2002). Let’s face facts: Common factors are more potent than specific therapy ingredients. Clinical Psychology: Science and Practice, 9, 21–25. doi:10.1093/clipsy/9.1.21.
Mohammed, S. N., & Thombre, A. (2005). HIV/AIDS stories on the world wide web and transformation perspective. Journal of Health Communication, 10(4), 347–360. doi:10.1080/10810730590950066.
Morisky, D. E., Stein, J. A., Chiao, C., Ksobiechm, K., & Malow, R. (2006). Impact of a social influence intervention on condom use and sexually transmitted infections among establishment-based female sex workers in the Philippines: A multilevel analysis. Health Psychology, 25(5), 595–603. doi:10.1037/0278-6133.25.5.595.
Morisky, D. E., Tiglao, T. V., Sneed, C. D., Tempongko, S. B., Baltazar, J. C., Detels, R., et al. (1998). The effects of establishment practices, knowledge and attitudes on condom use among Filipina sex workers. AIDS Care, 10(2), 213–220. doi:10.1080/09540129850124460.
National Institutes of Health. (2000). Interventions to prevent HIV risk behaviors. NIH consensus development conference. February 11–13, 1997. AIDS (London, England), 14(Suppl 2), S1–S96.
National Institute of Mental Health Intervention Workgroup, Bellack, A., Elkin, I., Flay, B., et al. (November, 2001). An integrated framework for preventive and treatment interventions. Presented at the National Institute of Mental Health Intervention Workgroup Meeting, Washington, DC.
Noguchi, K., Albarracin, D., Durantini, M. R., & Glasman, L. R. (2007). Who participates in which health promotion programs? A meta-analysis of motivations underlying enrollment and retention in HIV-prevention interventions. Psychological Bulletin, 133(6), 955–975. doi:10.1037/0033-2909.133.6.955.
O’Donnell, C. R., O’Donnell, L., San Doval, A., Duran, R., & Labes, K. (1998). Reductions in STD infections subsequent to an STD clinic visit: Using video-based patient education to supplement provider interactions. Sexually Transmitted Diseases, 25(3), 161–168. doi:10.1097/00007435-199803000-00010.
Patterson, C. H. (1984). Empathy, warmth, and genuineness in psychotherapy: A review of reviews. Psychotherapy (Chicago, Ill.), 21, 431–438. doi:10.1037/h0085985.
Rapkin, B., & Trickett, E. J. (2005). Comprehensive dynamic trial designs for behavioral prevention research with communities: Overcoming inadequacies of the randomized controlled trial paradigm. In E. J. Trickett & W. Pequenaut (Eds.), Community interventions and AIDS. New York: Oxford University Press.
Rosenzweig, S. (1936). Some implicit common factors in diverse methods of psychotherapy. The American Journal of Orthopsychiatry, 6, 412–415.
Rotheram-Borus, M. J., & Duan, N. (2003). Next generation of preventive interventions. Journal of the Academy of Child and Adolescent Psychiatry, 42(5), 518–526. doi:10.1097/01.CHI.0000046836.90931.E9.
Rotheram-Borus, M. J., Duan, N., & Flannery, D. (2004). Interventions that are CURRES: Cost-effective, useful, realistic, robust, evolving, and sustainable. In H. Remschmidt, M. L. Belfer, & I. Goodyer (Eds.), Facilitating pathways: Care, treatment, and prevention in child and adolescent mental health. Heidelberg, Germany: Sprigner-Verlag Telos.
Rotheram-Borus, M. J., Koopman, C., Haignere, C., & Davies, M. (1991). Reducing HIV sexual risk behaviors among runaway adolescents. Journal of the American Medical Association, 266, 1237–1241. doi:10.1001/jama.266.9.1237.
Rotheram-Borus, M. J., Lee, M., Leonard, N., Lin, Y. Y., Franzke, L., Turner, E., et al. (2003a). Four-year behavioral outcomes of an intervention for parents living with HIV and their adolescent children. AIDS (London, England), 17(8), 1217–1225.
Rotheram-Borus, M. J., Murphy, D. A., Wight, R. G., Lee, M. B., Lightfoot, M. A., Swendeman, D., et al. (2001). Improving the quality of life among young people living with HIV. Evaluation and Program Planning, 24, 227–237. doi:10.1016/S0149-7189(01)00013-1.
Rotheram-Borus, M. J., Song, J., Gwadz, M., Lee, M., Van Rossem, R., & Koopman, C. (2003b). Reductions in HIV risk among runaway youth. Prevention Science, 4(3), 173–187. doi:10.1023/A:1024697706033.
Rotheram-Borus, M. J., Ingram, B. L., Swendeman, D., & Flannery, D. (In submission). Common principles imbedded in effective adolescent HIV prevention programs.
Sumartojo, E. (2000). Structural factors in HIV prevention: Concepts, examples, and implications for research. AIDS, 14(Suppl 1), S3–S10.
Acknowledgement
National Institute of Mental Health grant P30MH58107 supported this research.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rotheram-Borus, M.J., Swendeman, D., Flannery, D. et al. Common Factors in Effective HIV Prevention Programs. AIDS Behav 13, 399–408 (2009). https://doi.org/10.1007/s10461-008-9464-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10461-008-9464-3