|
Critical Thinking Cultural Affirmation (CTCA)
Curriculum Guide for Health Providers - 2009 RELEASE
The Critical Thinking Cultural Affirmation (CTCA) health strategy has gained national acclaim for its innovation. The American
Journal of Public Health featured the strategy; and, behavioral scientists acknowledged it as one of few promising practices
for African Americans at risk for HIV and other health challenges. CTCA is a novel, and culturally congruent intervention
designed to reduce risk behaviors and improve psychosocial outcomes. The San Francisco Universitywide AIDS Research Program
selected the model, and is currently collaborating with Charles Drew University of Medicine and Science and the University
of California, Los Angeles Neuropsychiatric Institute for further research. Since its development, the CTCA model has been
replicated nationally for African American men, women and youth in health. To date, CTCA is the only intervention of its kind
in the nation that successfully reduced HIV/AIDS risk behaviors among 80% of Black males in a pilot study.
Guiding research on CTCA constitutes a focus point for current qualitative research, including on UCLA's MAALES Project.
HIV related to men having sex with men (MSM) is the single major contributor to HIV infection among Blacks (CDC), accounting
for an estimated 50% of all US AIDS cases diagnosed among Black men and a substantial but unknown percentage of cases diagnosed
among Black women. The MAALES Project is a culturally congruent intervention guided by the CTCA model to reduce HIV risk-related
behaviors in a community sample of non-gay identifying (NGI) African American MSM.
The study is being conducted by UCLA in two phases: Phase 1: The Formative Phase informs issues pertinent to sexual and
drug risk-taking practices among African American NGI MSM as described by focus groups with NGI African American MSM and women
who have had NGI African American MSM partners and by in-depth interviews with direct service staff and other systems representatives.
Phase 2: Testing the Intervention is piloting the MAALES risk-reduction and comparison health promotion interventions with
participants. Study implementation involves randomizing 208 participants to revised versions of one of the two conditions
to test the effectiveness of the intervention, designed to address the cultural, ethnic, socioeconomic, and secrecy issues
that may influence HIV risk among NGI African American MSM and their partners.
Specific aims of the study include: 1) using formative research to adapt the CTCA Model for HIV prevention, community
building, and empowerment among NGI African American MSM, 2) testing whether NGI African American MSM in the risk-reduction
intervention (MAALES Project) report a lower incidence of sexual risk behavior (increased condom use for anal and vaginal
sex, decreased numbers of sexual partners, and decreased sex while using drugs) than NGI African American MSM in the health
promotion intervention at post-intervention and 3-month follow-up, 3) evaluating the effectiveness of using the risk-reduction
intervention among NGI African American MSM to promote testing for HIV and other sexually transmitted diseases, and 4) testing
whether key variables such as age, socioeconomic status, sexual and drug history, and current psychological distress moderate
the intervention effect. This information will help to tailor interventions to subgroups of NGI African American MSM.
***This curriculum guide profiles basic principles utilized in the CTCA intervention and integrates evaluation data and
findings from the past 20 years.
|
