Feasibility of a group-based self-management program for ethnically diverse people with HIV/AIDS in Hawaii

HIV/AIDS has transformed from a terminal to a chronic health condition affecting individuals for decades rather than years. Yet the development of care models that enhance client-focused HIV disease management skills is still in progress, especially in HIV resource-poor locales. This pilot study tested the feasibility of implementing the group-based Positive Self-Management Program (PSMP) to participants recruited from Oahu, Hawaii. The PSMP is a self-management program developed at Stanford University. A paucity of data exists on the efficacy of implementing the specialized PSMP that addresses unique needs of persons living with HIV. With a focus on enhancing self-efficacy beliefs, examples of topics addressed during seven weekly 2-hr group sessions include managing the physiological and psychological aspects of HIV, adherence to treatment regimes, symptom management, and fostering healthy lifestyle behaviors. Using a randomized waitlist control design, participants were recruited via convenience sampling and active outreach. The manualized PSMP was delivered by trained seropositive lay leaders. The completion rate for those who attended any sessions was 93.5%. The average attendance rate was 85%. The majority of participants reported being comfortable in the PSMP group setting and very satisfied with program activities. Almost all participants reported that the PSMP was a useful and easy method to learn new ways of managing their illness. The majority (93.8%) were most satisfied with skill development in goal setting and action planning. Implementation of the program for persons living with HIV in Hawaii was feasible. Lessons learned for future research and application to practice are discussed.