背景:东非的捕鱼社区经历了两个相互关联且经常共同发生的健康问题的沉重负担:艾滋病毒和有害酒精使用。近三分之二的乌干达渔民符合有害酒精使用标准。我们开发了一种多层次的干预措施,以减少有害酒精的使用,并改善Wakiso地区感染艾滋病毒的渔民(LWHIV)的艾滋病毒护理参与,乌干达。
方法:这是对利益相关者关于适当性的观点的定性研究,可接受性,以及对渔民LWHIV进行多层次干预的可行性。拟议的干预措施,Kisoboka(“这是可能的!”),将结构成分[将工作支付方式从现金更改为移动货币]与行为成分[基于动机性访谈的咨询与使用行为经济学原理促进行为改变的内容相结合]相结合。我们进行了一个焦点小组(n=7)和八个对渔民LWHIV的深入访谈,以及对卫生工作者的19个关键线人(KI)访谈,雇主,和社区领袖。这些探索了适当性,可接受性,以及具体关键干预组件的可行性。
结果:总体而言,利益相关者的观点支持高干预可接受性和对拟议干预措施的适当性。人们认为这是可行的,并提出了一些建议,以克服已确定的潜在实施挑战(例如,如果一个人无法自己写的话,请有一个朋友协助记录储蓄和酒精使用情况)。
结论:这项工作突出了Kisoboka干预的潜力以及关键利益相关者早期参与干预制定过程以确保适当性的重要性,可接受性,可行性,和社会文化契合。
BACKGROUND: East Africa\'s fishing communities experience a high burden of two interrelated and frequently co-occurring health issues: HIV and hazardous alcohol use. Nearly two-thirds of Ugandan
fisherfolk men meet the criteria for harmful alcohol use. We developed a multilevel intervention to reduce hazardous alcohol use and improve HIV care engagement among
fisherfolk men living with HIV (LWHIV) in Wakiso district, Uganda.
METHODS: This is a qualitative study of stakeholder perspectives on the appropriateness, acceptability, and feasibility of a multilevel intervention for
fisherfolk men LWHIV. The proposed intervention, Kisoboka (\"It is possible!\"), combines a structural component [changing the mode of work payments from cash to mobile money] with a behavioral component [motivational interviewing-based counseling combined with content using behavioral economic principles to promote behavior change]. We conducted one focus group (n=7) and eight in-depth interviews with
fisherfolk men LWHIV and 19 key informant (KI) interviews with health workers, employers, and community leaders. These explored the appropriateness, acceptability, and feasibility of specific key intervention components.
RESULTS: Overall, stakeholders\' perspectives supported high intervention acceptability and perceived appropriateness of the proposed intervention. It was perceived to be feasible with some caveats of recommendations for overcoming potential implementation challenges identified (e.g., having a friend assist with documenting savings and alcohol use if an individual was unable to write themselves) which are discussed.
CONCLUSIONS: This work highlights the potential of the Kisoboka intervention and the importance of early engagement of key stakeholders in the intervention development process to ensure appropriateness, acceptability, feasibility, and socio-cultural fit.