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 奖项的目标是支持 Jennifer Velloza 博士发展成为独立的 艾滋病毒和心理健康研究人员，重点是改善综合心理健康干预措施的实施 Velloza 博士是该中心的流行病学家和博士后研究员。 华盛顿大学。该提案概述了一个为期 5 年的培训和研究计划，以培养她的能力。 以人为本的设计和实施科学的正式培训 培训计划：确保过渡到。 独立后，Velloza 博士组建了一支由导师和顾问组成的多学科团队，他们在以下领域具有专业知识： 为南非提供以人为本的设计、实施科学以及 PrEP 和心理健康服务 他们通过会议和相关内容制定了强有力的培训计划。 K99 的培训目标是： 1) 熟练掌握以人为本的干预设计。 2）应用实施科学工具来确定整合心理的实施策略 PrEP 实施中的健康干预；以及 3) 通过领导试验来测试和优化 这些目标建立在她之前的经验基础上。 培训和支持她的长期职业目标：非洲 AGYW 面临着高艾滋病毒和艾滋病感染率。 PrEP 是一种高效的艾滋病毒预防方法，正在南方推广。 然而，常见精神障碍的症状是非洲和南方使用 PrEP 的重大障碍。 非洲卫生部越来越重视针对 AGYW 提供 PrEP 的分层方法。 有效的心理健康治疗，例如问题解决疗法（PST），有可能与 PrEP 交付旨在解决心理健康挑战和可改变的 PrEP 使用障碍并改善 PrEP 友谊长凳是 AGYW 的一个有前途的基于证据的 PST 干预选项。 鉴于它是为在繁忙的艾滋病毒诊所中提供而开发的，目前正在南方扩大规模 非洲，初步数据表明它可以用于提高非洲人艾滋病毒治疗的依从性 需要进行研究来调整干预内容，评估心理健康和 PrEP 的有效性。 遵守结果，并确定 AGYW 在 PrEP 实施环境中的实施策略。 该提案的目标是调整、测试和优化非洲 AGYW 在 PrEP 交付中的友谊工作台。 具体目标是： 1) 确定心理健康干预的内容以及实施的障碍 PrEP 诊所；2) 设计和试点青年友谊工作台 SA 内容和实施策略；3) 开展 一项混合 II 型试验，旨在评估 Youth Friendship Bench SA 对 PrEP 依从性的初步有效性，同时 优化 PrEP 实施中的成本限制；以及 4) 确定干预主题 这些目标与 Velloza 博士的培训目标相符，她将成为一名独立的人。 科学家为围绕心理健康和艾滋病毒预防服务提供的高度优先问题做出贡献。