Adaptation and optimization of the Friendship Bench mental health intervention for adolescent girls and young women in South African PrEP delivery settings

南非 PrEP 分娩环境中针对少女和年轻女性的友谊长凳心理健康干预的调整和优化

• 批准号: 10159614
• 负责人: Jennifer Velloza
• 金额: $ 12.2万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-11 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10159614
• 关键词: AIDS prevention; Accounting; Address; Adherence; Africa South of the Sahara; African; Age; Anxiety; Award; Behavioral; Behavioral Sciences; Characteristics; Clinic; Communities; Complex; Consolidated Framework for Implementation Research; Counseling; Data; Development; Discrimination; Educational workshop; Effectiveness; Ensure; Epidemiologist; Epidemiology; Face; Feedback; Female Adolescents; Friendships; Goals; HIV; Health; Health Priorities; Healthcare; High Risk Woman; Human; Human immunodeficiency virus test; Incidence; Individual; Intervention; Interview; Link; Manuals; Measures; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mentors; Outcome; Perception; Persons; Pharmaceutical Preparations; Population; Postdoctoral Fellow; Prevention approach; Process; Publishing; Randomized; Reproductive Health; Research; Research Personnel; Risk; Scientist; Services; South Africa; South African; Specific qualifier value; Stress; Surveys; Symptoms; Testing; Therapeutic Intervention; Training; Training Support; Universities; Washington; Woman; Work; Youth; Zimbabwe; adolescent health outcomes; base; career; common symptom; coping; cost; design; effectiveness evaluation; effectiveness implementation study; effectiveness implementation trial; evidence base; experience; gender-based violence; health care delivery; hybrid type 2 trial; implementation barriers; implementation cost; implementation science; implementation strategy; improved; innovation; insight; intervention effect; meetings; multidisciplinary; persistent symptom; pre-exposure prophylaxis; preference; prevention service; problem solving therapy; programs; prototype; psychologic; scale up; service delivery; social stigma; standard of care; therapy design; tool; treatment adherence; treatment arm; young woman

ABSTRACT The goal of the proposed K99/R00 award is to support Dr. Jennifer Velloza’s development into an independent HIV and mental health researcher, with a focus on improving delivery of mental health interventions integrated with HIV prevention services for young women. Dr. Velloza is an epidemiologist and postdoctoral fellow at the University of Washington. This proposal outlines a 5-year training and research plan to build her capacity with formal training in human-centered design and implementation science. Training Plan: To ensure transition to independence, Dr. Velloza has assembled a multidisciplinary team of mentors and advisors with expertise in human-centered design, implementation science, and PrEP and mental health service delivery for South African adolescent girls and young women (AGYW). They have crafted a robust training plan with meetings and relevant coursework. The training goals for the K99 are to: 1) Gain proficiency in human-centered design for intervention adaptation; 2) Apply implementation science tools to identify implementation strategies for integrating a mental health intervention in PrEP delivery; and 3) Transition to independence by leading a trial to test and optimize a mental health intervention for South African AGYW in PrEP settings. These goals build on her prior experience and training and support her long-term career goals. Research Plan: African AGYW face high rates of HIV and common mental disorders. PrEP is a highly effective HIV prevention approach which is being scaled up in South Africa. However, symptoms of common mental disorders are significant barriers to PrEP use and the South African Department of Health is placing increasing emphasis on layered approaches to PrEP delivery for AGYW. Effective mental health treatment, such as problem-solving therapy (PST), has the potential to be integrated with PrEP delivery to address mental health challenges and modifiable barriers to PrEP use and improve PrEP adherence for AGYW. The Friendship Bench is a promising evidence-based PST intervention option for AGYW in PrEP settings given that it was developed for delivery in busy HIV clinics, is currently being scaled-up in South Africa, and preliminary data suggests it can be adapted to improve HIV treatment adherence among African women. Research is needed to adapt intervention content, evaluate effectiveness on mental health and PrEP adherence outcomes, and identify implementation strategies for AGYW in PrEP delivery settings. The overall goal of this proposal is to adapt, test, and optimize the Friendship Bench for African AGYW in PrEP delivery. The Specific Aims are to: 1) Identify content for a mental health intervention and barriers to implementation in PrEP clinics; 2) Design and pilot Youth Friendship Bench SA content and implementation strategies; 3) Conduct a hybrid Type II trial to assess preliminary effectiveness of Youth Friendship Bench SA on PrEP adherence while optimizing implementation for cost constraints in PrEP delivery; and 4) Identify themes around intervention experiences. These aims correspond with Dr. Velloza’s training goals and she will emerge as an independent scientist contributing to high priority issues around mental health and HIV prevention service delivery.

抽象的 拟议的K99/R00奖的目标是支持Jennifer Velloza博士的发展成为独立的 艾滋病毒和心理健康研究人员，重点是改善整合心理健康干预措施的交付 为年轻妇女提供预防艾滋病毒服务。 Velloza博士是一位流行病学家和博士后研究员 华盛顿大学。该提案概述了一项为期5年的培训和研究计划，以建立她的能力 以人为本的设计和实施科学进行正式培训。培训计划：确保过渡到 独立，Velloza博士组建了一个由指导者组成的多学科团队，并拥有专业知识 以人为中心的设计，实施科学以及南非的精神卫生服务提供 青春期女孩和年轻女性（AGYW）。他们制定了一项强大的培训计划，会议和相关 课程。 K99的培训目标是：1）熟练掌握以人为本的设计进行干预 适应; 2）应用实施科学工具来确定整合心理的实施策略 预付款交付中的健康干预； 3）通过领导试验测试和优化一个试验过渡到独立性 南非AGYW在准备环境中的心理健康干预措施。这些目标以她先前的经验为基础 培训并支持她的长期职业目标。研究计划：非洲AGYW面临高艾滋病毒和 常见的精神障碍。 PREP是一种非常有效的HIV预防方法，正在南方缩放 非洲。但是，常见精神疾病的症状是预备使用的重大障碍，南方 非洲卫生部正在越来越强调分层的AGYW准备方法。 有效的心理健康治疗，例如解决问题的疗法（PST），有可能与 准备交付以应对精神健康挑战和可修改的障碍，以准备并改善准备 遵守Agyw。友谊长凳是AGYW的承诺基于证据的PST干预选择 在准备设置中，鉴于它是在繁忙的艾滋病毒诊所开发的，目前正在南方扩大 非洲和初步数据表明，它可以改善非洲的艾滋病毒治疗依从性 女性。需要研究以适应干预内容，评估对心理健康的有效性和准备 遵守结果，并确定AGYW在准备交付环境中的实施策略。总体 该建议的目标是适应，测试和优化非洲AGYW的友谊台。 具体目的是：1）确定用于心理健康干预措施的内容和实施障碍 预科诊所； 2）设计和飞行员青年友谊台式SA内容和实施策略； 3）行为 一项II型混合试验，用于评估青年友谊板SA对预备的初步有效性，而 优化预备交付中成本限制的实施； 4）确定围绕干预的主题 经验。这些目标与Velloza博士的培训目标相对应，她将成为独立的 科学家在心理健康和艾滋病毒预防服务提供方面提出了高度优先问题。