Implementation Science to Strengthen the Integrated Care Continuum in Getting to Zero Contexts

实施科学以加强实现零环境的综合护理连续体

• 批准号: 10349562
• 负责人: Moira McNulty
• 金额: $ 17.03万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-03-01 至 2023-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10349562
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adopted; Adoption; Automobile Driving; Caring; Cities; Clinical Investigator; Collaborations; Continuity of Patient Care; Data; Data Sources; Decision Making; Development; Epidemiology; Evaluation; Event; Exploration Preparation Implementation and Sustainment; Feedback; Goals; Government Agencies; HIV; HIV Seronegativity; HIV Seropositivity; Health Services; Health Services Research; Healthcare; Human immunodeficiency virus test; Illinois; Individual; Infrastructure; Intervention; K-Series Research Career Programs; Knowledge; Leadership; Link; Mentored Patient-Oriented Research Career Development Award; Mentorship; Methods; Modeling; Monitor; National Institute of Mental Health; Outcome; Patient-Focused Outcomes; Periodicity; Persons; Population; Population Surveillance; Positioning Attribute; Prevention; Process; Process Assessment; Public Health; Readiness; Reporting; Research; Research Personnel; Resources; Services; System; Testing; Time; Training; Viral; base; career development; complex data; diverse data; effective intervention; evidence base; experience; future implementation; implementation framework; implementation intervention; implementation research; implementation science; implementation strategy; improved; knowledge of results; pre-exposure prophylaxis; preventive intervention; programs; recruit; scale up; skills; success; surveillance data; tool; transmission process; treatment as prevention; AIDS prevention; Acquired Immunodeficiency Syndrome; Address; Adopted; Adoption; Automobile Driving; Caring; Cities; Clinical Investigator; Collaborations; Continuity of Patient Care; Data; Data Sources; Decision Making; Development; Epidemiology; Evaluation; Event; Exploration Preparation Implementation and Sustainment; Feedback; Goals; Government Agencies; HIV; HIV Seronegativity; HIV Seropositivity; Health Services; Health Services Research; Healthcare; Human immunodeficiency virus test; Illinois; Individual; Infrastructure; Intervention; K-Series Research Career Programs; Knowledge; Leadership; Link; Mentored Patient-Oriented Research Career Development Award; Mentorship; Methods; Modeling; Monitor; National Institute of Mental Health; Outcome; Patient-Focused Outcomes; Periodicity; Persons; Population; Population Surveillance; Positioning Attribute; Prevention; Process; Process Assessment; Public Health; Readiness; Reporting; Research; Research Personnel; Resources; Services; System; Testing; Time; Training; Viral; base; career development; complex data; diverse data; effective intervention; evidence base; experience; future implementation; implementation framework; implementation intervention; implementation research; implementation science; implementation strategy; improved; knowledge of results; pre-exposure prophylaxis; preventive intervention; programs; recruit; scale up; skills; success; surveillance data; tool; transmission process; treatment as prevention

PROJECT SUMMARY In this career development proposal, I aim to use implementation science strategies for evaluation of the integrated care continuum within a Getting to Zero (GTZ) Framework. GTZ frameworks propose expansion and scale-up of effective HIV treatment and prevention interventions such as pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP), with the goal of eliminating new HIV transmission events. GTZ initiatives are most commonly operationalized through integrated care continuums. The integrated care continuum describes HIV care and prevention steps for HIV positive and HIV negative, but susceptible, persons: both critical to ending HIV transmission. Many jurisdictions have undertaken systematic efforts to end HIV transmission through Getting to Zero initiatives. Challenges in implementation have occurred, with a primary one being monitoring, evaluating, and providing timely feedback for iterative improvements in the implementation strategy. In order to be efficient within constrained resources, GTZ efforts need to be systematically and routinely assessed to provide feedback for successful implementation – a data-driven cornerstone of implementation science. Developing and organizing monitoring and evaluation systems has been recognized as a discrete implementation strategy. There is a clear need to develop rigorous methods of evaluation within an implementation science framework that can provide public health implementers of GTZ plans clear and contemporary feedback, and serve as a tool driving cyclical improvements in integrated care continuum outcomes. For this career development proposal, I will use the Exploration, Preparation, Implementation, and Sustainment (EPIS) model to explore adoption of a GTZ evaluation tool in Illinois in collaboration with public health partners. Therefore, this proposal will 1) use an implementation framework to examine capacity, readiness and feasibility of key stakeholders to adopt diverse data sources to evaluate GTZ HIV elimination efforts, 2) demonstrate the appropriateness and feasibility of candidate data sources in evaluating the integrated care continuum through a case example, and 3) develop tools for evaluation of the integrated care continuum through data monitoring and feedback. The knowledge from this proposal will fill important gaps in how to provide context-specific implementation support in the form of monitoring, feedback, and evaluation within multi-pronged jurisdictional programs for HIV elimination. The resulting knowledge has the potential to drive service improvements for elimination efforts both in Illinois and other jurisdictions. This K award will provide advanced training in implementation research, health services, and mixed methods that will build on my background in epidemiology and HIV prevention. I will bring my research experience together with that of my strong mentorship team to develop the skills necessary to become an independent investigator. These experiences will position me to become a leader in the field of HIV prevention and implementation.

项目摘要 在这项职业发展建议中，我旨在使用实施科学策略来评估 集成护理继续在零（GTZ）框架中继续进行。 GTZ框架提案扩展和 扩大有效的HIV治疗和预防干预措施，例如预防前预防（PREP）和 作为预防（TASP）的治疗，目的是消除新的HIV传播事件。 GTZ倡议是 最常通过综合护理连续体操作。综合护理连续体描述 HIV护理和预防艾滋病毒阳性和艾滋病毒负面的步骤，但易感性的人： 结束HIV传播。许多司法管辖区已采取系统的努力来结束艾滋病毒的传播 通过达到零计划。实施挑战已经发生，主要是 监视，评估和提供及时的反馈，以进行实施的迭代改进 战略。为了在受限资源中有效，GTZ的努力需要系统地和 经常评估以提供成功实施的反馈 - 数据驱动的基石 实施科学。已经认识到开发和组织监测和评估系统 作为离散的实施策略。显然需要在内部开发严格的评估方法 一个实施科学框架，可以为GTZ计划的公共卫生实施者提供清晰的和 当代反馈，并作为综合护理连续体的工具驱动周期性改进 结果。对于这项职业发展建议，我将使用探索，准备，实施和 与公众合作，探索伊利诺伊州GTZ评估工具采用GTZ评估工具的模型 卫生伙伴。因此，该建议将1）使用实施框架检查能力， 主要利益相关者的准备和可行性采用多种数据源来评估GTZ HIV的演变 努力，2）证明候选数据源在评估候选数据源的适当性和可行性 综合护理继续通过案例示例，3）开发用于评估综合护理的工具 通过数据监视和反馈进行连续体。该提议的知识将填补重要空白 如何以监视，反馈和评估的形式提供特定于上下文的实施支持 在多管齐下的艾滋病毒消除司法管辖权计划中。由此产生的知识有可能 在伊利诺伊州和其他司法管辖区的消除工作方面的改善。这个K奖将 提供实施研究，卫生服务和混合方法的高级培训 我的流行病学和艾滋病毒预防背景。我将把我的研究经验与 我强大的精明团队发展成为独立调查员所需的技能。这些 经验将使我成为预防艾滋病毒和实施领域的领导者。