Linking Individual Faith Together with My Highly Active Antiretroviral Therapy (LIFT My HAART): A Two-Phased Grant Proposal Open Access
Wilkinson, Lea (2016)
Abstract
The number of children newly infected by HIV in low- and middle-income countries has fallen by 40%. This constitutes considerable progress towards the global scale-up of Prevention of Mother-to-Child Transmission (PMTCT) initiatives. For the first time in history, the Elimination of Mother-to-Child Transmission (EMTCT) is an attainable public health goal. For the past decade, Zambia has successfully implemented an efficient nationwide response to the HIV/AIDS epidemic within its borders. During this time, Zambia has worked hard as a nation to achieve key milestones in the coordination and management of their national response. However, a concerning trend is starting to take hold within the country that threatens Zambia's success in PMTCT. Mounting pressure is present in some Christian communities for both men and women to stop Antiretroviral therapy (ART) for the hope that God will heal them through prayer. Women are statistically more drawn to churches that teach this belief, which contributes to their decision to stop ART. For an HIV-positive pregnant woman, the decision to substitute prayer for Highly Active Antiretroviral Therapy (HAART) could impact the life of her unborn child through mother-to-child transmission (MTCT) of HIV. To leverage the role that Christian religion plays in an HIV-positive pregnant woman's decision-making, as a way to ensure improved HAART adherence and reduced MTCT, this grant proposal outlines a two-phased process targeting HIV-positive pregnant women and Christian leaders in Lusaka, Zambia. The first phase is a mixed-method investigation of both HIV-positive pregnant women and the local Christian leaders in Lusaka, Zambia. The research will help identify the factors that may impact HAART treatment adherence among this population. The second phase uses information gathered through key informant interviews and surveys to aid in the creation of a community based program designed to Link Individual Faith Together with HAART (LIFT My HAART). The purpose of the initiative is to influence how HIV-positive pregnant women are counseled by those they look to for spiritual guidance. The goal is to increase treatment adherence for HIV-positive pregnant women who identify with the Christian faith.
Table of Contents
Chapter I: Part A 10
Introduction 10
Figure 1.1: Relationship Between ARV Coverage and MTCT Rate in Zambia from 2009-2012 12
The Problem 12
Understanding the Problem 13
Women in Zambia 13
Religion in Zambia 14
Figure 1.2: Religious Representation in Zambia 15
Chapter I: Part B 17
Introduction 17
Target Audience 18
The Research Question and Hypotheses 18
Actions Prior to the Start of the Grant Activities 19
Phase I 20
Figure 1.3: Phase I Sampling Grid 21
Qualitative and Quantitative Research 21
Selection of Interviewing Facilities 21
Key Informant Interviews and Surveys 22
Selection of Survey Participants 22
Survey and Interview Constructs 24
Survey Constructs 24
Interview Constructs 26
Reasons for Exclusion from the Interview and Survey Pool 27
HIV-positive pregnant women 27
Christian Leaders 28
Data Collection Activities 28
Figure 1.4: LIFT My HAART Program Activities 28
Analysis of Qualitative Data 29
Analysis of Quantitative Data 29
Data Usage 29
Phase II - Program Implementation of LIFT My HAART 30
LIFT My HAART Program Outline 30
Figure 1.5: Social-Ecological Model 32
Recruitment of LIFT My HAART Program Participants 32
LIFT My HAART Program Activities 33
Figure 1.6: LIFT My HAART Program Activities 33
LIFT My HAART Follow-up 33
Dissemination Plan 34
Potential Barriers 34
Risks 35
Chapter 1 Part B Summary 36
Definition of Terms 38
Chapter II: Review of Literature 41
Introduction 41
Review of Literature 41
Religion and Health Related Behaviors 41
Healing Churches 42
Healing Churches, Women, HIV and ART 43
Summary of Current Problem and Study Relevance 44
Types of Funding Agencies 45
Chapter III: Methodology 47
Grant Announcement 47
Proposal Review Criteria 47
Significance 48
Innovation 51
Approach 52
The Grant Review Process 55
LIFT My HAART Grant Reviewers 56
Johanna M. Hinman, MPH, MCHES 56
Beth Anne Pratt, PhD. 56
Wendy Zijdel, RN, CNS 57
Katy Weinberg, MBA, BA 57
Elizabeth Egelski, MPH, BA 58
Chapter IV: Incorporation of Reviewer Comments 59
Reviewer 1 Comments: 59
Reviewer 2 Comments: 66
Reviewer 3 Comments: 73
Reviewer 4 Comments: 80
Reviewer 5 Comments: 85
Chapter V: Final Version of the Proposal 93
References 103
Appendix A: RFP 108
Appendix B: External Reviewer Form 132
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