| Project TALC |
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Teens & Adults Learning to CommunicateProgram Components
For Use With
Evaluation Methodology
Evaluation Findings
Evaluators' Comments: When a parent is infected with HIV, the family is influenced in a fundamental and long-term fashion, reflecting [the] pervasive impact of HIV on society. A small group cognitive behavioral intervention substantially improves parent and adolescent functioning over two years and gains remain in several important areas. Program DescriptionThis cognitive behavioral intervention, based on social learning theory, is designed to improve behavioral and mental health outcomes among adolescents and their parents who are living with AIDS. The program relies on an extensive manual, covering all activities and materials needed for each session and including sample scripts for each activity. Module 1, delivered over four consecutive Saturdays, includes eight sessions for the adults living with AIDS. Module 1 focuses on coping with illness, fear, anger, sadness and the meaning of illness and on deciding to disclose, disclosing, and planning for the future. Module 2, delivered over eight consecutive Saturdays, includes 16 sessions for the adults living with AIDS and separate, matched sessions for the adolescents. For example, the first session is "awareness of my children's needs" and the matched session is "making sense of my parent's illness." Other sessions include making custody plans and arrangements, listening and sharing, reducing problem behavior, coping, creating a positive home, resolving family conflicts, dealing with drugs and alcohol, preventing pregnancy or involvement in a pregnancy, encouraging safer sex, and goals for the future. [Module 2 is not appropriate for adolescents to whom his/her parent has not disclosed HIV status.] Participants meet in small groups of eight to 10 parents and eight to 10 adolescents each Saturday. Each week, some sessions separate adult and adolescent groups while others bring adults and adolescents into the same group. Finally, the program also provides free transportation as well as breakfast, lunch, and childcare. Evaluation MethodologyFrom August 1993 to March 1995, every financially needy person living with AIDS (PLA) who requested services from Division of AIDS Services in New York City was logged and in and considered for eligibility for this program. Researchers identified 429 eligible people who: were living with AIDS; were between the ages of 25 and 70; had at least one child between the ages of 11 and 18; were not institutionalized; and had assent from their social worker that participation was appropriate. Eighty-four percent (n=307) were traced and agreed to participate. Then, their adolescent children were approached about participating; 412 gave informed consent to participate. At the time of baseline assessment and interview, families (parent and all his/her adolescent children) were randomly assigned to the intervention condition (adults, n=153; adolescents, n=205) or standard care control (adults, n=154; adolescents, n=205) conditions. Because Module 2 relies on adolescents being aware of their parents' HIV status, 66 youth were dropped from the intervention, leaving 128 youth as participants in the intervention condition. Two-person teams conducted two-hour in-home interviews with parents and all adolescents in the household. Parents and adolescents were assessed in individual interviews at three-month intervals over 24 months, and subjects received $25.00 for each interview. Within each intervention condition, 95 percent of parents and youth were assessed at least once annually; 75 percent of the subjects completed over half (five of nine) possible assessments; 24 percent completed all nine assessments. Adolescents were assessed for emotional distress (Brief Symptom Inventory), stressful family events (Rosenberg Self-Esteem Scale), and problem behaviors, including unprotected sex, alcohol and drug use, contact with the justice system, trouble at school, and non-enrollment in school. Adults were also assessed for emotional distress (Brief Symptom Inventory), adult problem behaviors, coping mechanisms (Coping with Illness Questionnaire), and planning for their children's future. At baseline, differences among parents and adolescents were insignificant across conditions. For example, 33 percent of intervention parents were African American, as were 36 percent of standard care controls; 47 and 43 percent, respectively, were Latino; 20 and 19 percent, respectively, were male; 60 and 63 percent, respectively were currently abstinent as to alcohol and drug use; and 54 and 60 percent, respectively, were currently sexually abstinent. Among adolescents 35 percent of intervention youth were African American, as were 40 percent of standard care controls; 51 and 49 percent, respectively, were Latino; 46 and 48 percent, respectively, were male; 68 and 67 percent, respectively, were currently abstinent in regard to alcohol and drug use; and 72 and 71 percent, respectively, were currently sexually abstinent. Evaluators said, "Randomization was successful in that parents and adolescents were similar across conditions in regard to all background factors and outcome measures." Long-Term Impact
Note: This intervention had many statistically significant findings not directly related to the purpose of Science & Success.
Among the parents living with AIDS, Project TALC significantly:
For More Information, Contacthttp://chipts.ucla.edu/interventions/manuals/intervhra1.html |