@article{9d6591d8dee247ea925090761bc3d4e3,
title = "Challenges and opportunities in the science of research to practice: lessons learned from a randomized controlled trial of a sexual risk-reduction intervention for psychiatric patients in a public mental health system",
abstract = "OBJECTIVE: Human immunodeficiency virus (HIV) prevention efficacy trials with psychiatric patients have been conducted in research settings in high-resourced countries, establishing short-term efficacy for reducing sexual risk behavior. None has been implemented within systems of care. In the last decade, overcoming this research-to-practice gap has become a focus of implementation science. This paper describes the first and only HIV Prevention intervention trial for psychiatric patients conducted in real-world outpatient psychiatric settings facilitated by trained clinic-based providers.METHODS: The HIV Prevention intervention, which uses the Information-Motivation-Behavioral Skills model to achieve sexual risk-reduction, was rigorously adapted to the local context and clinic services' needs. Participants from eight clinics were randomized to HIV Prevention or Health Promotion conditions.RESULTS: HIV Prevention participants showed significant improvement in Information-Motivation-Behavioral domains; in this group, behavioral intentions were associated with significantly fewer unprotected sex occasions, but reduction of unprotected sex occasions was similar in both conditions.CONCLUSION: Our trial was conducted before implementation studies became widely funded. Transporting an intervention to a new culture or into real-world practice settings may require adaptations. Our results demonstrate that clear guidelines are needed regarding whether to conduct efficacy, effectiveness, and/or implementation research as the most appropriate next step.CLINICAL TRIAL REGISTRATION: NCT00881699.",
keywords = "Behavioral research, Intervention study, Prevention, Program effectiveness, Treatment efficacy",
author = "Wainberg, {Milton L.} and Mann, {Claudio G.} and Andrea Norcini-Pala and Karen McKinnon and Diana Pinto and Veronica Pinho and Cavalcanti, {Maria T.} and Leu Cheng-Shiun and Guimar{\~a}es, {Mark D.} and Paulo Mattos and Elizabeth Hughes and Palinkas, {Lawrence A.} and Laura Otto-Salaj and Remien, {Robert H.} and Francine Cournos and {PRISSMA Project}",
note = "Funding Information: This research was supported by grant R01 MH65163 (MLW) from the United States NIMH and a center grant from the United States NIMH to the HIV Center for Clinical and Behavioral Studies at NY State Psychiatric Institute and Columbia University (P30-MH43520; principal investigator: Anke A. Ehrhardt). The authors gratefully acknowledge the enormous contributions made to the PRISSMA Project by people receiving care at Instituto de Psiquiatria (IPUB), Universidade Federal do Rio de Janeiro (UFRJ), Instituto Municipal Philippe Pinel (IMPP), Centro Psiqui{\'a}-trico do Rio de Janeiro (CPRJ), Instituto Municipal Nise da Silveira, Centro de Atenc¸{\~a}o Psicossocial (CAPS) Sim{\~a}o Bacamarte (Santa Cruz), CAPS Profeta Gentileza (Inhoa{\'i}ba), CAPS Pedro Pellegrino (Campo Grande), and CAPS Clarice Lispector (Engenho de Dentro), and by mental health care providers and other staff at these institutions. PRISSMA team members: Alessandra da Silva Ramos, {\^A}ngelo Amado, Ariadna Patr{\'i}cia Estevez, Bianca Ramos, Bibiana Caccavo Machado, Carlos Lin-hares Veloso Filho, Carolina Xavier, Claudia Simone dos Santos Oliveira, Cristiane Borges, Daniel Os{\'o}rio, Deborah de Melo Ferreira, Fernanda Gomes Luz, Frederika de Assis Albuquerque, Gilberto de Sousa Alves, Glaucia Lamblet Ferreira, Isis Regina de Melo, Joana Darck dos Santos Reis, J{\'u}lia Biolchini, Juliana Hampshire Lopes, Karina Penido Ribeiro, L{\'u}cia, Rabelo Ferreira, Marcelo Ara{\'u}jo Miranda, Marcia de Oliveira Silviano, Maur{\'i}cio Vidal Matos, Michelle Gomes Albuquerque, M{\^o}nica Pinto do Carmo, M{\^o}nica Teixeira Ferreira, Nelson Borges, Ozenildo Pereira de Souza, Priscila Gribel de Souza, Regina Am{\'e}lia Senna, Regina dos Santos Jacinto, Rodrigo Dotto, Silvia Regina Lopes, Suely Broxado de Oliveira, Valeska Batista Guedes, Vandr{\'e} Matias Vidal. Funding Information: This research was supported by grant R01 MH65163 (MLW) from the United States NIMH and a center grant from the United States NIMH to the HIV Center for Clinical and Behavioral Studies at NY State Psychiatric Institute and Columbia University (P30-MH43520; principal inves-tigator: Anke A. Ehrhardt). The authors gratefully acknow-ledge the enormous contributions made to the PRISSMA Project by people receiving care at Instituto de Psiquiatria (IPUB), Universidade Federal do Rio de Janeiro (UFRJ), Instituto Municipal Philippe Pinel (IMPP), Centro Psiqui?-trico do Rio de Janeiro (CPRJ), Instituto Municipal Nise da Silveira, Centro de Atenc??o Psicossocial (CAPS) Sim?o Bacamarte (Santa Cruz), CAPS Profeta Gentileza (Inhoa?ba), CAPS Pedro Pellegrino (Campo Grande), and CAPS Clarice Lispector (Engenho de Dentro), and by mental health care providers and other staff at these institutions. PRISSMA team members: Alessandra da Silva Ramos, ?ngelo Amado, Ariadna Patr?cia Estevez, Bianca Ramos, Bibiana Caccavo Machado, Carlos Lin-hares Veloso Filho, Carolina Xavier, Claudia Simone dos Santos Oliveira, Cristiane Borges, Daniel Os?rio, Deborah de Melo Ferreira, Fernanda Gomes Luz, Frederika de Assis Albuquerque, Gilberto de Sousa Alves, Glaucia Lamblet Ferreira, Isis Regina de Melo, Joana Darck dos Santos Reis, J?lia Biolchini, Juliana Hampshire Lopes, Karina Penido Ribeiro, L?cia, Rabelo Ferreira, Marcelo Ara?jo Miranda, Marcia de Oliveira Silviano, Maur?cio Vidal Matos, Michelle Gomes Albuquerque, M?nica Pinto do Carmo, M?nica Teixeira Ferreira, Nelson Borges, Ozenildo Pereira de Souza, Priscila Gribel de Souza, Regina Am?lia Senna, Regina dos Santos Jacinto, Rodrigo Dotto, Silvia Regina Lopes, Suely Broxado de Oliveira, Valeska Batista Guedes, Vandr? Matias Vidal.",
year = "2020",
month = aug,
doi = "10.1590/1516-4446-2019-0737",
language = "English",
volume = "42",
pages = "349--359",
journal = "Brazilian Journal of Psychiatry",
issn = "1516-4446",
publisher = "Associacao Brasileira de Psiquiatria",
number = "4",
}