title: Nurse-delivered counselling intervention for parental HIV disclosure: results from a pilot randomized controlled trial in China.
abstract: OBJECTIVE
  The objective of this study was to design and conduct a preliminary evaluation of an intervention to assist parents in decision-making about disclosure of their HIV diagnosis to their children.
  
  
  METHODS
  This was a pilot randomized controlled trial (RCT) with blinded assessment. Participants were randomized to intervention or treatment-as-usual (TAU) arms.
  
  
  METHODS
  The study occurred at an outpatient HIV primary care centre in Shanghai, China.
  
  
  METHODS
  Participants were 20 HIV-positive outpatients with at least one child (13-25 years old) who was unaware of the parent's HIV diagnosis.
  
  
  METHODS
  The nurse-delivered intervention involved three, hour-long, individual sessions over 4 weeks. Intervention content comprised family assessment, discussion of advantages and disadvantages of disclosure, psycho-education about cognitive, social and emotional abilities of children at different developmental stages, and disclosure planning and practicing via role-plays.
  
  
  METHODS
  Primary study outcomes for intervention versus TAU arms were self-reported disclosure distress, self-efficacy, and behaviours along a continuum from no disclosure to full disclosure and open communication about HIV.
  
  
  RESULTS
  In all cross-sectional (Wald tests) and longitudinal (general estimating equations) analyses, at both postintervention (4 weeks) and follow-up (13 weeks), effects were in the hypothesized directions. Despite the small sample size, most of these between-arm comparisons were statistically significant, with at least one result for each outcome indicating a 'large' effect size.
  
  
  CONCLUSIONS
  Our results suggest that nurses are able to deliver a counselling intervention in a clinic setting with the potential to alleviate parental distress around HIV disclosure to their children. Findings warrant future trials powered for efficacy.
authors.affiliation: aDepartment of Psychology bSchool of Social Work, University of Washington, Seattle, Washington cSchool of Nursing, Yale University, Orange, Connecticut dSchool of Interdisciplinary Arts and Sciences, University of Washington Bothell, Bothell, Washington, USA eShanghai Public Health Clinical Center, Fudan University, Shanghai, P.R. China.
authors.forename: Jane M
authors.initials: JM
authors.lastname: Simoni
authors.forename: Joyce P
authors.initials: JP
authors.lastname: Yang
authors.forename: Cheng-Shi
authors.initials: CS
authors.lastname: Shiu
authors.forename: Wei-Ti
authors.initials: WT
authors.lastname: Chen
authors.forename: Wadiya
authors.initials: W
authors.lastname: Udell
authors.forename: Meijuan
authors.initials: M
authors.lastname: Bao
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.forename: Hongzhou
authors.initials: H
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D002681:China; D003376:Counseling / Q000379:methods; D003430:Cross-Sectional Studies; D003657:Decision Making; D015658:HIV Infections / Q000451:nursing / Q000523:psychology; D008137:Longitudinal Studies; D010290:Parents / Q000523:psychology; D010865:Pilot Projects; D014342:Truth Disclosure; D016032:Randomized Controlled Trials as Topic