Abstract
The study will focus on the way HIV treatment compliance is affected by social support among African American women with HIV. This paper identifies data collection tools used for research, including published (the Multidimensional Scale of Perceived Social Support) and creates (the questionnaire for treatment compliance measurement) ones. It describes dependent and independent variables and mentions possible confounding.
Each year more people are diagnosed with HIV even though this issue is widely discussed and a lot of interventions are made to reduce its incidence. Women, especially African Americans, are reported to be among the most affected segment of the population (Galvan, Davis, Banks, & Bing, 2008). As a rule, they are young females of childbearing age. To save their lives and protect the rest of society, professionals developed various approaches to virologic suppression. They emphasize the necessity to maintain HIV therapies compliance to achieve positive outcomes but being affected by stigma many women are afraid to talk about their problems (Edwards, 2006). This study will discuss this issue trying to prove that social support and the way it is perceived by African American females affects HIV treatment adherence and allows them to cope with negative influences.
Instrumentation
A cross-sectional epidemiological study will be conducted to gather the information needed for research. Such approach meets the needs of the study better than others. It provides an opportunity to measure disease occurrence within the particular population (Bonita, Beaglehole, & Kjellström, 2006). With its help, an opportunity to discover the relationship between HIV treatment compliance and another element that attracts a lot of interest in this perspective – social support – will be obtained. A cross-sectional study will also be rather advantageous because it allows conducting research over a short period. The results received due to it, will be rather useful for the planning and allocation of health resources (Rothman, Greenland, & Lash, 2008).
Published Instruments
To collect data considering social support, the Multidimensional Scale of Perceived Social Support (MSPSS) will be used. This instrument was created by Zimet, Dahlem, Zimet, and Farley at the end of the 20th century. It was published by these professionals in 1988. Back then, it could be found in the Journal of Personality Assessment (Akhtar et al., 2010). According to it, the focus is made on family, friends, and significant other. This brief research tool will provide an opportunity to concentrate on the assessment of perceived social support, which fits this research. Its internal reliability and good validity were proved through numerous studies, which ensures that it can be utilized in this paper. In addition to that, the fact that the MSPSS was translated into more than 20 languages proves that it is highly valued by scientists and healthcare professionals all over the world. For example, it was used by Galvan et al. (2008) in their research that focused on a similar topic. They identified that the “subscale for perceived social support from family had an α reliability score of 0.93, for perceived social support from friends 0.92 and a special person 0.96” (Galvan et al., 2008).
Instruments to Create
There is a necessity to create an instrument that can be used to discuss HIV treatment compliance. Of course, it could be possible to use direct and indirect adherence measures offered by Lam and Fresco (2015), such as the number of pills used, blood or urine and evaluation, or prescription-refilling, etc. Still, such approach does not meet peculiarities of a cross-sectional survey, so it will be better to think of another instrument.
It will be advantageous to create a written questionnaire that can be maintained with all participants in a relatively short period of time. Some tools for measuring medication adherence exist, but they are not focused on HIV treatment. Culig and Leppée (2014) gathered those that are frequently used in their article, identifying their advantages and drawbacks. So a questionnaire for this study will be developed on their basis so that it will meet its peculiarities. The focus will be made on medication intake and its frequency. The validity of the questionnaire will be tested with the stakeholders’ attitude, fellow-researchers’ assessment, and connection of its content with the purpose of the study. The reliability will be ensured focusing on the similar assessment tools, used as the basis for this one (Polgar & Thomas, 2011). This instrument will show how the sample maintains HIV treatment compliance, which perfectly fits the research question, providing data for one of the variables.
Operationalization of Variables
The proposed cross-sectional epidemiological study will be based on the evaluation of the relationship between two variables. The independent variable will be social support. It will include such segments as the family, friends, and significant other, and coded accordingly in three categories. It will be measured with the MSPSS and scores 1-7. The dependent variable will be HIV treatment compliance. It will reveal the frequency of treatment intake and will be measured with scores 1-4. The variable will be coded continuously.
Exposure: it will be advantageous to measure HIV stigma because it affects people’s treatment decisions through additional questions about alcohol abuse and depression (Velentgas, Dreyer, & Nourjah, 2013).
Outcomes: how social support affects HIV treatment (interpreting results).
Covariates: demographic characteristics of the sample (age categories).
Potential confounders: access to treatment, marital status, and dependents.
Scales
The MSPSS will be used as a scale that reveals how the sample treats the segments of social support. The participants of the study will circle numbers from 1 to 7, which will reveal their attitudes starting with “very strongly disagree” and ending with “very strongly agree”. When focusing on this scale, the subscales for each of its elements of social support will be discussed separately so that the results can be considered in detail. The mean reported scores will show sample’s feeling and will provide an opportunity to measure social support. Standard deviations will be included to show how the views of different people altered, which will provide an opportunity to speak about some tendencies.
One more scale will be found in the created questionnaire. It will be a scale used for the measurement of HIV treatment compliance. The sample will fill it out themselves. The scale will start with “0 – never” and end with “4 – all the time”. While answering the questions, the participants of the study will provide data considering their medication adherence. The results will be gathered to obtain the mean reported score, based on which conclusions can be made. The lowest numbers will prove that treatment compliance is poor while the highest ones will show that the sample takes all needed medication. Standard deviations will be mentioned to reveal the differences in the obtained answers.
Confounding
The sample may have different access to treatment, which will affect their possibility to adhere to it. Their income, social status and even place of living can be influential. Marital status and dependents affect the range of social support. Some participants may have no family members alive or close to them. This confounding can be measured when gathering information about the sample so that it can be discussed along with other results.
References
Akhtar, A., Rahman, A., Husain, M., Chaudhry, I., Duddu, V., & Husain, N. (2010). Multidimensional scale of perceived social support: psychometric properties in a South Asian population. Journal of Obstetrics and Gynaecology Research, 36(4), 845-51.
Bonita, R., Beaglehole, R., & Kjellström, T. (2006). Basic epidemiology. Geneva, Switzerland: World Health Organization.
Culig, J., & Leppée, M. (2014). From Morisky to Hill-Bone; Self-reports scales for measuring medication adherence. Collegium Antropologicum, 38(1), 55–62.
Galvan, F., Davis, M., Banks, D., & Bing, E. (2008). HIV Stigma and Social Support among African Americans. AIDS Patient Care STDS, 22(5): 423–436.
Edwards, L. (2006). Perceived social support and HIV/AIDS medication adherence among African American women. Qualitative Health Research, 16(5), 679-91.
Lam, W., & Fresco, P. (2015). Medication adherence measures: An overview. BioMed Research International, 2015, 1-12.
Polgar, S., & Thomas, S. (2011). Introduction to research in the health sciences. Amsterdam, Netherlands: Elsevier Health Sciences.
Rothman, K., Greenland, S., & Lash, T. (2008). Modern epidemiology. New York, NY: Lippincott Williams & Wilkins.
Velentgas, P., Dreyer, N., & Nourjah, P. (2013). Developing a protocol for observational comparative effectiveness research: A user’s guide. Rockville, MD: Agency for Healthcare Research and Quality.