Williams AB, Bova C, Burgess JD, Danvers K, Malone J, Saunders L, Winfield S, Odesina V; International Conference on AIDS.
Int Conf AIDS. 2002 Jul 7-12; 14: abstract no. ThPeF8189.
Yale University, New Haven, United States
ISSUES: Medication adherence is a challenge for most people living with HIV. Many adherence interventions are developed in clinical settings, while medications must be taken in the home or community. DESCRIPTION: The ATHENA project (Adherence Through Home Education and Nursing Assessment) uses a home visiting team (nurse and peer educator) guided by the educational principles of Paulo Freire to encourage patients to explore how the social context limits or facilitates their ability to adhere to medication regimens. Through reflection/action/reflection, the team and patient interact as critical thinkers to identify social and personal sources of adherence problems and develop potential responses to those problems. Freire's educational strategy of codification allows the team to portray themes (e.g. stigma, lack of voice, racism) uncovered in discussion. Codification techniques include role playing, stories, pictures, cartoons, poetry, and music. Discussion of themes are framed as problem posing dialogue and patients are encouraged to take action to change their situation when appropriate. LESSONS LEARNED: Patients actively engage in critical thinking in the safe environment of the home, although establishing trust may require several months. The intervention promotes development of self care behaviors that support adherence, such as obtaining treatment for depression or addiction, improving diet and eating habits, establishing a consistent medication schedule despite chaotic social situations, and confronting discrimination. RECOMMENDATIONS: Assessment of medication adherence and interventions to improve adherence should be implemented in the home and community. A diverse team guided by Freirian principles can be a powerful tool to encourage activities that improve self care and medication adherence. This approach can be adapted for a variety of countries and cultures.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Educational Status
- HIV Infections
- House Calls
- Humans
- Patient Education as Topic
- Peer Group
- Self Care
- Teaching
- Teaching Materials
- education
- methods
- organization & administration
Other ID:
UI: 102253616
From Meeting Abstracts