GODDESS (Gathering Online for Dialogue and Discussion to Enhance Social Support): Engaging young African American women in a virtual group app to address alcohol misuse, sexual risk, and PrEP in NC

GODDESS（在线聚集进行对话和讨论，以加强社会支持）：让年轻的非裔美国女性参与虚拟团体应用程序，以解决北卡罗来纳州的酒精滥用、性风险和 PrEP 问题

• 批准号: 10541028
• 负责人: Felicia Amira Browne
• 金额: $ 60.5万
• 依托单位: RESEARCH TRIANGLE INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10541028
• 关键词: AIDS prevention; AIDS/HIV problem; Address; Adoption; Affect; African American; African American population; Alcohol consumption; Alcohols; Area; Asian; Behavior Therapy; Biological; Biological Testing; COVID-19; COVID-19 morbidity; COVID-19 risk; Cellular Phone; Centers for Disease Control and Prevention (U.S.); Collaborations; Communities; County; Coupled; Data; Data Analytics; Drug usage; Enrollment; Epidemic; Evidence based intervention; Feedback; Focus Groups; Goals; HIV; HIV Seronegativity; HIV diagnosis; Health; Heavy Drinking; Impairment; Incidence; Individual; Intervention; Interview; Measures; Methods; Modification; North Carolina; Outcome; Participant; Patient Self-Report; Persons; Population; Populations at Risk; Prevention; Process; Public Health; Reduce health disparities; Research; Research Activity; Research Priority; Resources; Risk; Risk Reduction; Sexually Transmitted Diseases; Social support; Support Groups; Surveys; Tablets; Technology; Testing; Time; United States National Institutes of Health; Unsafe Sex; Violence; Woman; Work; aged; alcohol and other drug; alcohol misuse; arm; base; biobehavior; cost; critical period; epidemiologic data; evidence base; experience; health disparity; implementation outcomes; innovation; intervention delivery; mHealth; mortality; multi-racial; peer support; pre-exposure prophylaxis; prevent; prevention service; randomized trial; reduced alcohol use; research study; response; satisfaction; service providers; sex; sexual HIV transmission; uptake; violence prevention; virtual; young woman

PROJECT SUMMARY/ABSTRACT The intersection between alcohol and other drug (AOD) use among young African American women at risk for HIV is a public health issue. Recent epidemiological data highlight increases in alcohol misuse among young African American women, especially since COVID-19. These issues are coupled with persistent disparities in HIV and other sexually transmitted infections (STIs) for young African American women. Eliminating persistent disparities in HIV acquisition is key to ending the HIV epidemic, particularly in the U.S. South. Consequently, there is a critical need to decrease alcohol use and impaired sex and to increase pre-exposure prophylaxis (PrEP) uptake as prevention for this key population. The proposed study builds on decades of research of a best-evidence woman-focused intervention, including collaboration with health departments to address AOD use, sexual risk, and violence prevention. Most recently, the study team found the delivery of the intervention via mobile health (mHealth) had findings comparable with face-to-face delivery, with reduced odds of heavy alcohol use and impaired sex, suggesting that scalability via mHealth is a viable option. The next logical step is to add and test a virtual group component, as recent participant feedback across several studies with African American women in North Carolina has shown additional group engagement and support is highly desired. Consequently, in response to RFA-AA-21-016: HIV Prevention and Alcohol, this application addresses the following specific aims: Aim 1. To modify an evidence-based mHealth AOD use and sexual risk reduction intervention to include a virtual group component and information about PrEP for utilization. Initial research activities include focus group discussions with 24 African American young women who misuse alcohol and 16 service providers, as well as pretesting of the virtual group component. This brief iterative process will include modifications and refinements based on content (PrEP) and technology (from tablet to smartphone) and will include review from our Community Collaborative Board. Aim 2. To test the modified mHealth intervention (with the group component) relative to the mHealth intervention in a two-arm randomized trial with young African American women (aged 18 to 30) who misuse alcohol. A total of 500 participants who are HIV-negative who engage in heavy alcohol use will be enrolled across two North Carolina counties and referred to their local health departments for PrEP. Primary biobehavioral outcomes assessed will include reduced alcohol use (self-reported and biological, including PEth), increased PrEP uptake (self-reported and biological), and reduced sexual risk (self-reported condomless sex and impaired sex and biological testing for HIV/STIs) at 3-, 6-, 9-, and 12-month follow-ups. Aim 3. To assess acceptability, adoption, and cost of the virtual group component as a strategy to increase engagement with the mHealth intervention and PrEP utilization. Acceptability will be assessed via satisfaction surveys and post-study interviews, adoption via data analytics measuring engagement in the group and examined as a meditator of intervention outcomes, and cost via data collected about time and resources of implementing the group component.

项目概要/摘要 年轻非洲裔美国女性饮酒和使用其他药物 (AOD) 之间的交叉点 艾滋病毒风险是一个公共卫生问题。最近的流行病学数据突显了酒精滥用的增加 年轻的非裔美国女性，尤其是自新冠肺炎 (COVID-19) 以来。这些问题与 年轻非洲裔美国人在艾滋病毒和其他性传播感染 (STI) 方面的持续差异 女性。消除艾滋病毒感染方面持续存在的差异是结束艾滋病毒流行的关键，特别是在 美国南部。因此，迫切需要减少饮酒和性行为障碍，并 增加暴露前预防 (PrEP) 的使用，作为这一关键人群的预防措施。 拟议的研究建立在数十年以女性为中心的最佳证据干预研究的基础上， 包括与卫生部门合作解决 AOD 使用、性风险和暴力预防问题。 最近，研究小组发现通过移动医疗（mHealth）提供干预措施有发现 与面对面分娩相当，酗酒和性功能受损的几率降低，这表明 通过移动医疗实现可扩展性是一个可行的选择。下一个逻辑步骤是添加并测试虚拟组 部分，正如最近参与者对北方非裔美国妇女的几项研究的反馈 卡罗莱纳州表现出了更多的团体参与度，并且非常需要支持。因此，响应 根据 RFA-AA-21-016：艾滋病毒预防和酒精，此应用程序旨在实现以下具体目标： 目标 1. 修改基于证据的 mHealth AOD 使用和性风险降低干预措施，以 包括虚拟组组件和有关 PrEP 的信息以供使用。初步研究活动 包括与 24 名滥用酒精的非裔美国年轻女性进行焦点小组讨论以及 16 名服务 提供商以及虚拟组组件的预测试。这个简短的迭代过程将包括 基于内容（PrEP）和技术（从平板电脑到智能手机）的修改和完善，并将 包括我们社区协作委员会的审查。 目标 2. 测试相对于 mHealth 的修改后的 mHealth 干预措施（包含团体部分） 对年轻非裔美国女性（18 至 30 岁）进行的一项双组随机试验的干预措施 滥用酒精。总共 500 名 HIV 阴性且酗酒的参与者将被 在北卡罗来纳州的两个县进行了登记，并向当地卫生部门转介进行 PrEP。基本的 评估的生物行为结果将包括减少饮酒（自我报告的和生物的，包括 PEth），增加 PrEP 摄取（自我报告和生物学），并降低性风险（自我报告） 在 3、6、9 和 12 个月的随访中进行无套性行为和性行为受损以及 HIV/STI 生物检测）。 目标 3. 评估虚拟群组组件作为一项策略的可接受性、采用率和成本 增加对移动医疗干预和 PrEP 利用的参与。将评估可接受性 通过满意度调查和研究后访谈，通过数据分析衡量参与度 小组并通过收集的时间和成本数据作为干预结果和成本的冥想者进行检查 实施组组件的资源。