title: The Positive Outlook Study: A Randomised Controlled Trial Evaluating Online Self-Management for HIV Positive Gay Men.
abstract: The aim of this paper was to evaluate the effectiveness of an online self-management program in improving health outcomes and well-being for gay men living with HIV in Australia. The online Positive Outlook Program was based on self-efficacy theory and used a self-management approach to enhance HIV-positive gay men's skills, confidence and abilities to manage the psychosocial issues associated with HIV in daily life. The 7-week program was delivered in closed groups and comprised information modules, action-planning activities, moderated discussion boards, and weekly peer-facilitated 'live chats'. A randomised controlled trial was conducted to establish the effectiveness of the Positive Outlook program compared to a 'usual care' control. Participants were HIV-positive gay men 18 years or older living in Australia. Primary outcomes were evaluated at three time-points (baseline, post-intervention and 12-week's post-intervention follow-up) and included HIV-related quality of life (PROQOL-HIV), outcomes of health education (HeiQ) and HIV specific self-efficacy (Positive Outlook Self-Efficacy Scale). A total of 132 gay men with HIV in Australia were randomly allocated to the intervention (n = 68) or usual care control (n = 64) groups. Maximum likelihood marginal-linear modelling indicated significant improvement in the intervention group on the PROQOL-HIV subscales of body change (p = 0.036), social relationships (p = 0.035) and emotional distress (p = 0.031); the HeiQ subscales of health-directed activity (p = 0.048); constructive attitudes and approaches (p = 0.015); skill and technique acquisition (p = 0.046) and health service navigation (p = 0.008); and the Positive Outlook Self-Efficacy Scale on the subscales of relationships (p = 0.019); social participation (p = 0.006); and emotions (p = 0.041). Online delivery of self-management programs is feasible and has the potential to improve quality of life, self-management skills and domain specific self-efficacy for gay men with HIV.
authors.affiliation: Department of Infectious Diseases, Monash University, Level 2 Burnet Tower, 85 Commercial Road, Melbourne, 3004, Australia. tanya.millard@monash.edu.
authors.forename: Tanya
authors.initials: T
authors.lastname: Millard
authors.affiliation: Centre for Population Health, Burnet Institute, Melbourne, Australia.|Judith Lumley Centre, La Trobe University, Melbourne, Australia.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Agius
authors.affiliation: Department of Infectious Diseases, Monash University, Level 2 Burnet Tower, 85 Commercial Road, Melbourne, 3004, Australia.|Judith Lumley Centre, La Trobe University, Melbourne, Australia.|Jean Hailes Research Unit, Monash University, Melbourne, Australia.|Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia.
authors.forename: Karalyn
authors.initials: K
authors.lastname: McDonald
authors.affiliation: Centre for Social Research in Health, University of New South Wales, Sydney, Australia.
authors.forename: Sean
authors.initials: S
authors.lastname: Slavin
authors.affiliation: School of Occupational Therapy and Social Work, Curtin University, Perth, Australia.
authors.forename: Sonya
authors.initials: S
authors.lastname: Girdler
authors.affiliation: Department of Infectious Diseases, Monash University, Level 2 Burnet Tower, 85 Commercial Road, Melbourne, 3004, Australia.|Centre for Population Health, Burnet Institute, Melbourne, Australia.|Infectious Diseases Unit, Alfred Hospital, Melbourne, Australia.
authors.forename: Julian H
authors.initials: JH
authors.lastname: Elliott
mesh_terms: D001315:Australia; D015658:HIV Infections / Q000523:psychology* / Q000628:therapy; D006801:Humans; D020407:Internet; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D010379:Peer Group; D015397:Program Evaluation; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care / Q000379:methods / Q000523:psychology*; D020377:Self Efficacy; D000072339:Sexual and Gender Minorities / Q000523:psychology*
keywords: HIV; Internet; Online; Positive Outlook Program; Quality of life; Randomised controlled trial; Self-management; Web-based