Health Clinical Trial
Official title:
TEA (Together for Empowerment Activities)for Families and Children: A Randomized Intervention Trial
The impact of HIV/AIDS is negatively influencing the affected families and their next generation. HIV is radiating through the extended families, shifting the life patterns not only for the parents living with HIV/AIDS (PLH), but also for their children, partners, and other family members. To help PLHs and their family members, the TEA intervention has been developed, refined and piloted in the previous study. The goal of this study is to implement the TEA intervention in a full scale to determine its efficacy and the potential for enhancing HIV policy and programs that support HIV-affected families to cope with the challenges in China in responding to the global HIV epidemic.
This 5-year project is a randomized controlled trial of the TEA (Together for Empowerment
Activities) intervention, a family intervention for HIV-affected families in rural areas of
China.
The impact of HIV/AIDS is negatively influencing the affected families and their next
generation. Currently in China, there are about 740,000 families living with HIV and 105,000
of them have developed AIDS. HIV is radiating through the extended families, shifting the
life patterns not only for the parents living with HIV/AIDS (PLH), but also for their
children, partners, and other family members. The negative impact of HIV is compounded by
Chinese tradition of accepting illness stoically and not discussing difficult issues within
the family due to shame and fear. Chronic illness also reverses the Chinese traditional
family roles especially when the ill parents are not capable of contributing to housework or
providing financial stability and the further burden rests on the children. As a result, the
relationship between parents, family members and children is significantly strained. To help
PLHs and their family members, the TEA intervention has been developed, refined and piloted
in the previous study. The goal of this study is to implement the TEA intervention in a full
scale to determine its efficacy and the potential for enhancing HIV policy and programs that
support HIV-affected families to cope with the challenges in China in responding to the
global HIV epidemic.
TEA intervention will have six sessions (plus a preparation session) delivered at three
levels simultaneously: 1) TEA Gathering (small group for PLH and their family members), 2)
TEA Time (home-based family activities with children that accompany each TEA Gathering), and
3) TEA Garden (community events that build social integration). Built on the successful
pilot work by the collaborative team, this intervention trial will include 24 administrative
villages with 20 families each, resulting in a total of 480 participating families affected
by HIV. The administrative villages will be randomized into two groups (12 villages in
each): TEA intervention group and control group (with 240 families in each group). A total
of 240 PLH, 240 family members and 360 children at age of 6-18 will be recruited in each
group. After the baseline assessment, the TEA intervention will be conducted in the
intervention group, but not in the control group. Follow-up assessments will be conducted at
6, 12, 18 and 24 months after the intervention is delivered. The impact of the intervention
will be assessed by comparing the outcomes measures at baseline and 6-, 12-, 18- and
24-month follow-ups between the intervention and control groups for HIV-affected families,
including PLH, family members, and children in poor, rural areas in China (Figure 1). The
primary outcomes are children's health, mental health, and behavioral adjustment. The
secondary outcomes will be the PLH's and family members' physical health, mental health, and
quality of life, as well as family indicators such as family daily routines, positive
interactions, parenting, coping, and community integration.
The study will be implemented in Anhui, China. Four counties, Lixin, Funan, Yinzhou and
Linquan in Anhui Province have been selected as project sites based on the sample size of
HIV-affected families and similarity of demographics. Within the selected counties, the
administrative villages that have 20 or more HIV-affected families with at least one child
aged 6-18 have been identified based on the current epidemiological data, resulting in a
total of 24 villages for this study. Through a randomization procedure, 12 villages will be
randomized to TEA intervention group and 12 villages to control group. Only the families
that have one PLH, at least one family member, and at least one child aged at 6-18 years
will be invited to participate. We will recruit all families from each of the villages,
resulting in a total of about 480 HIV-affected families with 480 PLHs, 480 family members
and 720 children.
The purpose of this study is to develop a feasible and practical intervention strategy
through a randomized controlled intervention trial, which will help HIV-affected families in
rural areas of China to face the challenges of HIV and improve their health and quality of
life.
The Specific Aims of the study are:
1. To test that the children in the intervention group, compared to those in the control
group, will have significantly better physical health, mental health, and behavioral
outcomes.
2. To test that the PLH and family members in the intervention group, compared to those in
the control group, will have significantly improved physical health, mental health, and
quality of life outcomes.
3. To investigate how outcomes of the children, PLH, and family members are mediated by
family indicators such as consistent daily routines, positive family interactions,
parenting, coping, and community integration.
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Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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