Determinants of Adherence to HIV Medication in Adolescents Living in Constanta, Romania . A Qualitative Application of the Information-Motivation-Behavioral (IMB) skills model. Ana-Maria Schweitzer, Baylor Black Sea Foundation, Constanta, Romania - PowerPoint PPT Presentation
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Information / Misinformation How the medications are supposed to be taken Side effects If I feel ok, it’s ok to skip medications Skipping medications does not affect health
If I cannot take one of the pills, it is ok to take only the others
If I take the strongest pill, I can skip the others I can interrupt pill-taking if my blood tests are fine It is important to take pills every day, irrespective
Motivation (barriers / facilitators) Fear of being seen by other people Frustration about “having a limited freedom” Good relationship with healthcare provider Social support
Future plans for family, profession Hope that a cure will be found sooner or later Fear of being sick and hospitalized Discouraged by death of friends under treatment
Conclusions How did the model do given Ware et al.'s
(2006) key questions? Relevance – the model’s 3 core concepts were not
directly tested, but used as a basis for the focus group guideResults suggest that Information, Motivation, and Behavioural Skills are relevant for our population
Comprehensiveness – no new concepts emerged (e.g. compared to African settings)
Accurateness – new themes within the 3 core concepts emerged (e.g. specific to long term treatment experience, adolescence, relationships)
Complexity – the variety of outputs extracted from raw data allow us to approach adherence flexibly in clinical practice
Limitations: convenience sampling, social desirability
Cognitive-behavioral Determinants Of Adherence Among Hiv-positive Adolescents In Romania
This study is supported by a grant from BIPAI and the Abbott Fund and developed by the Baylor Black Sea Foundation at the Centrul Clinic de Excelenta - Spitalul Clinic de Boli Infectioase Contanta - Baylor College of Medicine - Texas Children’s Hospital – Abbott Fund
Team of investigators : R.B.Wanless1, A.L.Dima2, A.-M. Schweitzer3, L.Vlahopol3 , E.A. Caraveteanu3 ,
1 Baylor International Pediatric AIDS Initiative, Houston, 2University of Edinburgh, Clinical and Health Psychology, Edinburgh, UK 3Baylor Black Sea Foundation Romania, Constanta, Romania, 4University of Connecticut, Connecticut, United States, 5 Facultad de Psicología, Universidad Autónoma de Madrid, 6 Institutul de Virusologie Stefan Nicolau, Romania, 7 Spitalul Clinic de Boli Infectioase, Romania
Fisher, J.D., Fisher, W.A., Amico, R., & Harman, J.J. (2006). An information-motivation-behavioral skills model of adherence to antiretroviral therapy. Health Psychology, 25(4), 462-473
Ware, N. C., Wyatt, M.A. & Bangsberg, D. (2006). Examining Theoretical Models of Adherence for Validity in Resource-limited Settings: A Heuristic Approach.” Journal of Acquired Immune Deficiency Syndromes. 43(S1):S18-S22