Teens and Adults Learning to Communicate (TALC: LA)

Mothers with AIDS and Their Adolescent Children

At a glance:

Project Type: 

Living with HIV

Teens and Adults Learning to Communicate

Project TALC was funded by the National Institute of Mental Health (NIMH) to evaluate the efficacy of a family-based intervention over time and to contrast the life adjustments of HIV-affected families and their non-HIV-affected neighbors in the current treatment era. Mothers living with HIV (MLH; n = 339) and their school-age children (n = 259) were randomly assigned to receive a behavioral intervention or standard care as the control condition. MLH and their children were compared to non-HIV-affected families recruited at neighborhood shopping markets.

Targeted Risk Group: 

HIV-positive mothers and their adolescent children

 

Links to Interventions, Training Manuals, etc. : 

 Phase 1 – Taking Care Of Myself

Parents’ Curriculum

Phase 2 – Illness

Parents’ Curriculum

  1. TALC LA- Parents Phase 2, Sess 1: What Are My Children's Needs? (902)
  2.  TALC LA- Parents Phase 2, Sess 2: Who Will Take Care of My Children? (892)
  3.  TALC LA- Parents Phase 2, Sess 3: What Kind of Arrangements Can I Make? (889)
  4.  TALC LA- Parents Phase 2, Sess 4: How Do I Start My Plan? (886)
  5.  TALC LA- Parents Phase 2, Sess 5: How Can I Really Listen To My Children? (899)
  6.  TALC LA- Parents Phase 2, Sess 6: How Can I Tell My Children What I Feel? (889)
  7.  TALC LA- Parents Phase 2, Sess 7: How Should I Deal with Problem Behavior? (895)
  8.  TALC LA- Parents Phase 2, Sess 8: How Can We Create a Positive Atmosphere at Home? (893)
  9.  TALC LA- Parents Phase 2, Sess 9: How Can We Resolve Conflicts at Home? (Part 1) (895)
  10.  TALC LA- Parents Phase 2, Sess 10: How Can We Resolve Conflicts at Home? (Part 2) (922)
  11.   TALC LA- Parents Phase 2, Sess 11: How Can We Work Together on Selecting a Custodian? (890)
  12.  TALC LA- Parents Phase 2, Sess 12: How Can We Deal with Drugs and Alcohol? (910)
  13.  TALC LA- Parents Phase 2, Sess 13: How Do I Prevent Pregnancy and Fatherhood? (940)
  14.  TALC LA- Parents Phase 2, Sess 14: Where Am I in Making a Custody Plan? (884)
  15.  TALC LA- Parents Phase 2, Sess 15: How Can Mothers Encourage Safer Sex? (915)
  16.  TALC LA- Parents Phase 2, Sess 16: What is the Mother's Legacy and the Youth's Goals? (882)

 Adolescents’ Curriculum

Phase 3 – Adjustment

New Caregivers and Teens’ Curriculum

  1.  TALC LA- New Caregivers and Teens Phase 3, Sess 1: What Do Adolescents and Caregivers/Parents Need from Each Other? (911)
  2.  TALC LA- New Caregivers and Teens Phase 3, Sess 2: What Role Am I Playing and What Is Expected of Me? (896)
  3.  TALC LA- New Caregivers and Teens Phase 3, Sess 3: Dealing with Loss and Grief - Part I (896)
  4.  TALC LA- New Caregivers and Teens Phase 3, Sess 4 (Caregivers): Raising an Adolescent (911)
  5.  TALC LA- New Caregivers and Teens Phase 3, Sess 4 (Youths): Planning for My Future - Part I (899)
  6.  TALC LA- New Caregivers and Teens Phase 3, Sess 5: Dealing with Loss and Grief - Part II (901)
  7.  TALC LA- New Caregivers and Teens Phase 3, Sess 6: How Can We Improve Communication - Part I (Effective Expressing) (899)
  8.  TALC LA- New Caregivers and Teens Phase 3, Sess 7: Ways of Helping Someone Cope with Loss and Grief (920)
  9.  TALC LA- New Caregivers and Teens Phase 3, Sess 8: How Can We Improve Communication - Part II (Active Listening and Responding) (903)
  10.  TALC LA- New Caregivers and Teens Phase 3, Sess 9 (Caregivers): Caregiver Support (926)
  11.  TALC LA- New Caregivers and Teens Phase 3, Sess 9 (Youths): How Do I Achieve My Goals? (890)
  12.  TALC LA- New Caregivers and Teens Phase 3, Sess 10: (Joint) How Can We Deal With Anger in the Relationship? (924)
  13.   TALC LA- New Caregivers and Teens Phase 3, Sess 11: How Can I Cope with Sadness? (887)
  14.  TALC LA- New Caregivers and Teens Phase 3, Sess 12 (Caregivers): How Should I Deal with Problem Behavior? (912)
  15.  TALC LA- New Caregivers and Teens Phase 3, Sess 12 (Youths): How Do I Deal with Fear? (904)
  16.  TALC LA- New Caregivers and Teens Phase 3, Sess 13: How Do We Practice Safer Sex, Prevent Pregnancy, and Reduce Alcohol and Drug Use? (922)
  17.  TALC LA- New Caregivers and Teens Phase 3, Sess 14: How Can We Resolve Conflicts at Home? (1366)
  18.  TALC LA- New Caregivers and Teens Phase 3, Sess 15: How Can We Create a Positive Atmosphere at Home? (919)
  19.  TALC LA- New Caregivers and Teens Phase 3, Sess 16: Looking to the Future Together, What Can We Do? (890)

 

Young Adults’ Curriculum

  1.  TALC LA- Young Adults Phase 3, Sess 1: How Are Things Going? (920)
  2.  TALC LA- Young Adults Phase 3, Sess 2: Planning for My Future - Part I (900)
  3.  TALC LA- Young Adults Phase 3, Sess 3: Dealing with Loss and Grief - Part I (858)
  4.  TLC- Young Adults Phase 3, Sess 4: Where and How Can Young People Get Support? (930)
  5.  TALC LA- Young Adults Phase 3, Sess 5: Dealing with Loss and Grief - Part II (904)
  6.  TALC LA- Young Adults Phase 3, Sess 6: Ways of Coping with Loss and Grief (927)
  7.  TALC LA- Young Adults Phase 3, Sess 7: Planning for My Future (Part II) - How Do I Achieve My Goals? (890)
  8.  TALC LA- Young Adults Phase 3, Sess 8: Hearing and Getting Heard (957)
  9.   TALC LA- Young Adults Phase 3, Sess 9: How Can We Deal with Anger? (995)
  10.  TALC LA- Young Adults Phase 3, Sess 10: Relationships and Sex (Part 1) (911)
  11.  TALC LA- Young Adults Phase 3, Sess 11: Relationships and Sex (Part 2) (950)
  12.  TALC LA- Young Adults Phase 3, Sess 12: How Can I Cope with Sadness? (896)
  13.  TALC LA- Young Adults Phase 3, Sess 13: Pregnancy and Parenthood (913)
  14.  TALC LA- Young Adults Phase 3, Sess 14: How Do I Deal with Fear? (886)
  15.  TALC LA- Young Adults Phase 3, Sess15: How Can I Reduce Substance Use? (1067)
  16.  TALC LA- Young Adults Phase 3, Sess 16: Looking to the Future (904)

 

Intervention Model: 

Mothers and their adolescents attended a 16-session cognitive behavioral intervention over eight weeks. For MLH, intervention goals aimed to: 1) improve parenting while ill (i.e., reduce family conflict, improve communication, clarify family roles); 2) reduce mental health symptoms; 3) reduce sexual and drug transmission acts; and 4) increase medical adherence and assertiveness with medical providers. For adolescents, the intervention goals were to: 1) improve family relationships; 2) reduce mental health symptoms; 3) reduce multiple problem behaviors (e.g., drug use, criminal justice acts, school problems, teenage pregnancy); and 4) school retention.

Research Methods:

In a random assignment study, families assigned to take part in Project TALC were compared with families assigned to a control group on mental health and health behaviors, including sexual behavior and substance use. Both intervention and control families were compared to a neighborhood cohort, matched on sociodemographics. Because study participants were followed over two years, longitudinal random effect regression models were used to test the efficacy of the intervention.

 

Surveys and Scales Used:
  1. Living Situation, Including Neighborhood Problems (Perception of Neighborhood) (1027)
  2. Religion: Attendance and Experience (966)
  3. Financial, Labor, Educational Experience (1001)
  4. Loss and Grief (995)
  5. Treatment History (988)
  6. Social Support (1198)
  7. Romantic Relationships (1541)
  8. Needle Use and Sharing (1012)
  9. Reproductive Health (1096)
  10. Parentification (1196)
  11. Goals Scale (1027)
  12. Natural Mentors (932)
  13. Dealing with Mother's Illness (1041)
  14. AHIMSA Acculturation, Habits, and Interests Multicultural Scale for Adolescents (1286)
  15. Sexually Transmitted Disease (1243)
  16. Medication Adherence (1105)
  17. Educational (Academic) Experience (1047)
  18. Family Functioning Subscales (1206)
  19. Family Composition Scale (981)
  20. Employment/Labor Experience (1071)
  21. WHOQOL-BREF (1067)
  22. Self Harm: Suicide History (1136)
  23. CDC Sexual Behavior Questions (CSBQ) (2048)
  24. School History (1062)
  25. Detention/Jail History (1067)
  26. HIV Disclosure (1069)
  27. Alcohol and Other Drug Abuse (AOD) (1220)
  28. Adolescent Substance Use (1168)
  29. PTSD Index for DSM IV (Adolescent version) - UCLA (2477)
  30. Parker Parental Bonding Instrument (1023)
  31. PANAS (969)
  32. Network Assessment (987)
  33. Janis Self-Esteem Scale (1122)
  34. HIV Health Survey - Medical Outcomes Study (MOS) Social Support Survey (1045)
  35. Living Situation for Adolescents (1056)
  36. Life Outcome Expectancies (1045)
  37. Life Goals (1058)
  38. Life Events (1041)
  39. House Rules (1035)
  40. HIV - Related Incidents (991)
  41. Healthcare Utilization, Providers, and General Health Assessment: Including STD and Pregnancy (1070)
  42. HIV Testing (1090)
  43. General Medical History (1032)
  44. Multiple Problem Behavior - DSM Conduct Problems (DSMC) - Conduct Disorder (1122)
  45. Conflict Resolution - Conflict Tactics Scale (CTS) (1736)
  46. Adult-Adolescent Parenting Inventory (AAPI) (1230)
  47. Nutrition and Exercise (1059)
  48. Rosenberg Self-Esteem Scale (RSE) (1193)
  49. Dealing with Illness (1124)

Local Significance: 

There was a lack of significant findings for an intervention effect on HIV-transmission behaviors and mental health. HIV-transmission behaviors were low to begin with and participants had little room for improvement. The populations affected by the HIV epidemic in the U.S. have shifted over the past number of years since a similarly mounted intervention in New York City led to improvements. HIV interventions in the U.S. need to shift their focus to persons living with HIV who are experiencing substantial problems.

International Significance:

While the focus of U.S.-based HIV interventions need to shift, interventions for the general HIV population may be effective outside the U.S.