Our team of senior Zimbabwean investigators and US have significant experience, in adapting, designing and evaluating interventions. Our largest study in Zimbabwe was the CPOL Intervention Trial (Kelly, et al, 1997), implemented among young adult Zimbabweans, aged 18-30 in 30 rural communities. This study had an extensive formative research phase, whose overall purpose was to determine the feasibility of adapting the CPOL HIV/AIDS intervention to the context of the AIDS epidemic in Zimbabwe (NIMH, 2007a). In addition, it was used to ascertain levels of behavioral and biological risk (NIMH, 2007b), and assess behavioral determinants that would affect behavior, using the Integrated Behavioral Model (IBM) as a framework (Kasprzyk, et al., 1998). The formative quantitative epidemiological phase established behavioral and biological outcomes for the Trial, with a behavioral risk survey of 1600 randomly selected individuals in 32 rural villages. In addition, the Family Health Study also conducted an extensive formative phase. The formative phase was conducted in four stages, a: 1) community census; 2) health assessment; 3) pilot of battery assessment; and 4) qualitative study in which a) assessed the family impact of HIV, and determined psychosocial needs; and b) gathered feedback on the adapted intervention.
The purpose of the census was to enumerate families living in the pilot neighborhood chosen, in order to identify families with children between the ages of 12 and 18. The Health Assessment stage was conducted to identify families where one or both parents may have HIV or AIDS. All families with children between the ages of 12 and 18 were assessed using a health assessment, and all adults were offered HIV testing. Once families who had HIV or AIDS were identified, we conducted individual open-ended interviews with family members to determine the effects of HIV or AIDS on the family unit, assessed the psychosocial needs of the families with HIV or AIDS, and finally discussed the psychosocial intervention with them. We then piloted the intervention. When the formative phase was completed, the full study trial was implemented in two urban neighborhoods, in each of the two major cities in Zimbabwe.