Network-based interventions

  • 文章类型: Journal Article
    同伴倡导可以促进艾滋病毒保护行为,但对艾滋病毒感染者(PLWH)及其社交网络成员之间的预防宣传(PA)报告的一致性知之甚少.我们检查了这种一致性的患病率和相关性,及其与社交网络成员的针对性HIV保护行为的关联。对193名PLWH(索引参与者)及其599名社交网络成员(改变者)的数据进行了分析。Kappa统计数据测量了过去3个月中PA指数和改变报告之间的一致性。Logistic和多项回归评估了倡导一致性与改变避孕套使用和HIV检测行为之间的关系以及PA一致性的相关性。在PrEP讨论中,在0.3%的指数改变二元组中观察到倡导一致性,9%用于避孕套使用,18%用于艾滋病毒检测,26%的护理参与度,49%用于抗逆转录病毒使用讨论。报告使用避孕套的指数较少(23.5%与28.1%;[公式:见正文]=3.7,p=0.05)和艾滋病毒检测(30.5%与50.5%;[式:见正文]=25.3,p<0.001)PA发生。如果指数和改变是浪漫伴侣,则避孕套倡导一致性更高(OR=3.50;p=0.02),如果该指数比改变者年轻10岁,则更低(OR=0.23;p=0.02)。当两个人都报告了避孕套宣传时,与均未报告宣传的二元组相比(OR=3.90;p<0.001),并且与仅有指数报告这种宣传的二元组相比(OR=3.71;p=0.01)。年龄差异和关系状况影响倡导协议,对宣传的一致看法与增加的艾滋病毒保护行为有关。改变观念可能对行为改变至关重要,宣传改进宣传的战略。
    Peer advocacy can promote HIV protective behaviors, but little is known about the concordance on prevention advocacy(PA) reports between people living with HIV(PLWH) and their social network members. We examined prevalence and correlates of such concordance, and its association with the targeted HIV protective behavior of the social network member. Data were analyzed from 193 PLWH(index participants) and their 599 social network members(alters). Kappa statistics measured concordance between index and alter reports of PA in the past 3 months. Logistic and multinomial regressions evaluated the relationship between advocacy concordance and alter condom use and HIV testing behavior and correlates of PA concordance. Advocacy concordance was observed in 0.3% of index-alter dyads for PrEP discussion, 9% for condom use, 18% for HIV testing, 26% for care engagement, and 49% for antiretroviral use discussions. Fewer indexes reported condom use(23.5% vs. 28.1%;[Formula: see text]=3.7, p=0.05) and HIV testing(30.5% vs. 50.5%; [Formula: see text]=25.3, p<0.001) PA occurring. Condom advocacy concordance was higher if the index and alter were romantic partners(OR=3.50; p=0.02), and lower if the index was 10 years younger than the alter(OR=0.23; p = 0.02). Alters had higher odds of using condoms with their main partner when both reported condom advocacy compared to dyads where neither reported advocacy(OR=3.90; p<0.001) and compared to dyads where only the index reported such advocacy(OR = 3.71; p=0.01). Age difference and relationship status impact advocacy agreement, and concordant perceptions of advocacy are linked to increased HIV protective behaviors. Alters\' perceptions may be crucial for behavior change, informing strategies for improving advocacy.
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  • 文章类型: Journal Article
    将社会因素纳入疾病预防和控制工作是行为流行病学的一项重要工作。疾病传播与人类健康行为之间的相互作用,比如疫苗的摄取,导致生物和社会传染的复杂动态。通过利用社会传染的力量来改变行为和态度,通过基于网络的定位算法来最大化干预采用在很大程度上仍然是一个挑战。这里我们通过考虑多路复用网络设置来解决这个问题。个人位于两层网络上:疾病传播网络层和对等影响网络层。该疾病通过直接密切接触传播,而疫苗观点和摄取行为在潜在的虚拟网络中相互传播。我们的综合模拟结果表明,以亲疫苗支持者为初始种子的基于网络的靶向会显着影响疫苗的采用率并降低流行病爆发的程度。与在社区中分组或专业联系的个人相比,通过选择在意见网络中处于中心位置的个人,网络针对性干预措施要有效得多。我们的研究结果为基于网络的干预措施提供了见解,以在持续的流行病期间增加疫苗的信心和需求。
    Incorporating social factors into disease prevention and control efforts is an important undertaking of behavioral epidemiology. The interplay between disease transmission and human health behaviors, such as vaccine uptake, results in complex dynamics of biological and social contagions. Maximizing intervention adoptions via network-based targeting algorithms by harnessing the power of social contagion for behavior and attitude changes largely remains a challenge. Here we address this issue by considering a multiplex network setting. Individuals are situated on two layers of networks: the disease transmission network layer and the peer influence network layer. The disease spreads through direct close contacts while vaccine views and uptake behaviors spread interpersonally within a potentially virtual network. The results of our comprehensive simulations show that network-based targeting with pro-vaccine supporters as initial seeds significantly influences vaccine adoption rates and reduces the extent of an epidemic outbreak. Network targeting interventions are much more effective by selecting individuals with a central position in the opinion network as compared to those grouped in a community or connected professionally. Our findings provide insight into network-based interventions to increase vaccine confidence and demand during an ongoing epidemic.
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