Abstract #308  -  symposium: adapting champ positive: international perspectives. champ+ new york
Authors:   Presenting Author:   Professor Arvhin Bhana - Human Sciences Research Council
Additional Authors:  Dr Stacey Alicea, Prof Mary Mckay, Prof Claude  Mellins,
Aim: This presentation examines the development, implementation and evaluation of the CHAMP+ program for inner city New York adolescents to promote requisite family and adolescent skills for health-promoting behavior (sexual activity and HIV illness management). Specifically, the presentation examines family influences on youth mental health and health risk behaviors, as well as the role of youth status in this relationship and then describes how this data was used to inform the development of a family based mental health and prevention program for perinatally infected youth (CHAMP+). We also present data on the outcomes of a pilot of the CHAMP+ program.
Method / Issue: Data for this presentation come from two NIMH-funded studies: 1) Project CASAH, a longitudinal study of 206 perinatally infected HIV+ youth (PHIV+), 9-16 years old, and 134 HIV- youths (PHIV-) (perinatally HIV-exposed) living with their primary caregivers in New York City. Data collection occurred with youth and their caregivers at baseline and 18-month follow-up to understand the role of HIV status and individual, family and contextual factors in influencing mental health and risk behavior; 2) Based on study findings and principles of community-based participatory research, the CHAMP+ program was developed in collaboration with PHIV+ adolescents and their guardians to address family support and communication about puberty, sexuality, and HIV. The process of development and preliminary data from the pilot trials are presented.
Results / Comments: CASAH. Baseline results indicate high rates of psychiatric disorder in both groups with higher rates in the PHIV+ youth; 61% of PHIV+ vs. 49% of PHIV- youth met criteria for at least one disorder on the DISC, a structured psychiatric interview (OR=1.59; p < .05). Among sexually active youth, the mean age of onset of sexual behavior was 12.0 years for PHIV+ youth vs. 13.4 for PHIV- youth (p=.038). Follow-up data indicate a decline in rates of overall mental health disorders, but an increase in sexual and drug risk behavior. Across groups, mental health and health risk behaviors were correlated. Preliminary SEM findings suggest that family functioning factors, including caregiver mental health and caregiver-child relationship factors are related to youth mental health and sexual and drug risk behaviors. CHAMP+. Based on CASAH and community consultant data, a 10-session intervention for families of PHIV+ youth was developed and piloted with # kids at 2 hospitals. Preliminary analyses revealed significant improvements in child emotional symptoms (t=3.1, p < .01) and decreases in conduct problems (t=2.2, p < .05) and functional impairment (t=2.9, p < .05) at posttest. Further, families began to work more cooperatively on ART issues (t=2.0, p < .1) at 3-month follow-up. Process evaluation of the CHAMP+ pilot highlighted the importance of involving guardians in intervention design, implementation, and participation.
Discussion: Large numbers of PHIV+ youth are aging into adolescence in the US and abroad. Mental health and medication adherence difficulties must be addressed through contextually appropriate interventions that can be integrated into standards of care. Family and psychosocial factors that influence mental health and health risk behaviors must also be addressed in family-based HIV preventive interventions for this high-risk population.
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