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Translating an Evidence-Based Behavioral Intervention for Women Living with HIV into Clinical Practice: The SMART/EST Women’s Program

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Abstract

Background

The process of translating scientific findings into clinical and public health settings has only recently received priority attention within the scientific community.

Purpose

Fueled by “Funding Opportunity Announcements” from the National Institutes of Health and Centers for Disease Control and Prevention, scientists have begun to explore the pathways to effectively “transfer” promising research accomplishments into effective and sustainable service programs within the health care delivery system.

Method

Using Glasgow’s RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) model as a guide, this research team enrolled 428 socially disadvantaged, culturally diverse women living with HIV/AIDS to test the dissemination and implementation of an evidence-based behavioral intervention designed to improve and sustain the physical and emotional health of participants into the Community Health Center (CHC) setting when conducted by trained CHC staff.

Results

Findings demonstrate the ability of trained CHC staff group leaders to attain results equivalent or superior to those achieved when conducted by research staff on the three principal study outcomes: depression, medication adherence and HIV viral load. Four of five CHCs involved in the study also identified and successfully obtained funding to continue to run intervention groups, supporting the adoption and sustainability components of the translation model.

Conclusion

This study confirmed (a) the “translatability” of the Stress Management And Relaxation Training/Emotional Supportive Therapy (SMART/EST) Women’s Program, from academic to CHC settings in two geographic regions with high HIV prevalence among women, (b) the ability of local staff (using the “train the trainer” model) to successfully achieve program fidelity and clinical outcomes, and (c) the sustainability the program beyond the auspices of research support, through supportive CHC leadership securing continued program funding.

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Acknowledgements

The authors gratefully acknowledge support for these studies from Centers for Disease Control and Prevention R18PS000829, and National Institutes of Health/National Institutes of Mental Health R01MH55463 and R01MH61208. UMMSM Health Centers: Borinquen Health Center (Miami FL) and Jackson Memorial Hospital Special Immunology Clinic (Miami FL). UMMSM Staff: Olga Villar-Loubet, PsyD, Eliot Lopez, PhD, Laura Bruscantini, and Szonja Vamos. UMMSM CHC Facilitators: Oscar Galeon, Madeline Clemente, Phonia Theoc, Sheila Findlay, Samantha Ross, and Joel Jean Baptiste. CDN Health Centers: Bedford-Stuyvesant Family Health Center (Brooklyn, NY), Morris Heights Health Center (Bronx, NY), Metropolitan Family Health Center/Jersey City Family Health Center (Jersey City NJ). CDN Staff: Marleny Diaz-Gloster, MPH, Jafar Abbas, Rosario Hinojosa, Fidel Martinez, Jessica Pesantez, PsyD, and Barbara Warren, PsyD. CDN CHC Facilitators: Enid Knight, Ellen Cates, Eileen Scarinici, Tonya Williams, Elisha Cherry, William Mendez, Patricia Ospina, and Jennifer Collazo.

Conflicts of Interest

The authors have no conflicts of interest to declare.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Dominion Tower, Suite 404A, 1400 NW 10th Avenue, Miami, FL, 33136, USA

    Stephen M. Weiss, Maria Lopez, Ryan Cook & Deborah L. Jones

  2. Clinical Directors Network, New York, NY, USA

    Jonathan N. Tobin & Hannah Simons

  3. Center for Clinical and Translational Science, Rockefeller University, New York, NY, USA

    Jonathan N. Tobin

  4. Department of Epidemiology and Population Health, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY, USA

    Jonathan N. Tobin

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  1. Stephen M. Weiss
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  2. Jonathan N. Tobin
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  3. Maria Lopez
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  4. Hannah Simons
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  5. Ryan Cook
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  6. Deborah L. Jones
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Corresponding author

Correspondence to Stephen M. Weiss.

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Weiss, S.M., Tobin, J.N., Lopez, M. et al. Translating an Evidence-Based Behavioral Intervention for Women Living with HIV into Clinical Practice: The SMART/EST Women’s Program. Int.J. Behav. Med. 22, 415–424 (2015). https://doi.org/10.1007/s12529-014-9399-1

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  • DOI: https://doi.org/10.1007/s12529-014-9399-1

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