The implementation of a peer educator HIV intervention in community settings

在社区环境中实施同伴教育艾滋病毒干预

• 批准号: 8495423
• 负责人: MELISSA Ann DAVEY-ROTHWELL
• 金额: $ 9.84万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-01 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8495423
• 关键词: AIDS prevention; Acquired Immunodeficiency Syndrome; Behavior Therapy; Behavioral; Budgets; Centers for Disease Control and Prevention (U.S.); Client; Collaborations; Communities; Cost Analysis; Couples; Data; Data Collection; Development; Diffuse; Diffusion; Disease; Drug Rehabilitation Centers; Drug user; Education; Educational Intervention; Effectiveness; Effectiveness of Interventions; Environment; Epidemic; Evidence based intervention; Financial cost; Future; Goals; HIV; HIV risk; Health; Heterosexuals; Individual; Intervention; Journals; K-Series Research Career Programs; Knowledge; Learning; Life; Literature; Measurement; Mentors; Methodology; Methods; Network-based; Pharmaceutical Preparations; Populations at Risk; Prevention Research; Preventive Intervention; Process; Provider; Public Health; Reading; Registries; Research; Research Design; Research Personnel; Research Project Grants; Resources; Risk; Risk Behaviors; Risk Reduction; Sampling; Scientist; Services; Social Environment; Social Network; Staging; Telephone Interviews; Testing; Training; United States; Vaccines; base; career; community organizations; community setting; cost; cost effective; cost effectiveness; disorder prevention; economic evaluation; evidence base; experience; implementation science; improved; insight; meetings; member; men who have sex with men; mental health center; peer; prevention service; programs; repository; research to practice; self help; sex; skills; staff intervention; success; symposium; theories; therapy design; therapy development

DESCRIPTION (provided by applicant): Three decades into the epidemic, HIV continues to be a major public health problem. Many behavioral interventions have been shown to be effective at changing risk behaviors in controlled research environments. Efforts have also increased for moving evidence-based interventions (EBIs) from research to practice as part of federal initiatives such as the CDC's Diffusion of Effective Behavioral Interventions and SAMHSA's National Registry of Effective- based Programs and Practices. Limited research has examined the implementation processes of these interventions, especially peer education interventions in community settings. It is important to understand which interventions can effectively and cost-effectively implement the EBIs in real-world settings Up until this point in my career, my research has focused on identifying risk and protective factors for HIV in the social environment, specifically social networks. In addition, I have developed and evaluated behavioral interventions for at risk groups. My long-term career goal is to develop and disseminate cost-effective, sustainable interventions, in partnership with community agencies and to study their implementation process. My short-term goal, which is discussed in this Mentored Scientist K01 application, is to acquire mentoring, knowledge, and practical experience in the theories, study designs, and methodologies of 1) dissemination and implementation science to identify strategies to disseminate and study the implementation of evidenced-based interventions in real-world settings; 2) community engagement research to partner with community agencies in intervention development, dissemination, and implementation; and 3) economic evaluation methods to assess the costs of implementing interventions. My training goals are to 1) Obtain background in the empirical literature and theories/framework that guide dissemination and implementation of behavioral interventions in community settings. 2) Gain skills and knowledge in methodology, such as study design, measurement, and data collection, to study the implementation of interventions in community settings. 3) Acquire knowledge and application of theories and methods for community-engaged research and developing community partnerships for dissemination and implementation of interventions. 4) Become proficient in economic evaluations of the costs required to implement behavioral interventions in community settings. These goals will be achieved through mentor meetings, coursework and tutorials, webinars/seminars, directed readings, conferences, and a journal club. As a result of this career development award, I will become an independent researcher who develops and disseminates HIV prevention interventions through collaborations with community agencies for implementation in practical settings. The proposed research project will focus on a peer educator intervention for former and current drug users (The SHIELD intervention) that has been nationally disseminated by the CDC. The specific aims are to 1) examine organization, provider/staff, and intervention factors associated with stages of implementation of a social- network based peer education interventions (the SHIELD intervention); 2) investigate the relationships between barriers and facilitators and stages of implementation and explore strategies to overcome barriers to implementation; and 3) conduct an analysis of the agency and client costs associated with implementing a peer education intervention in community- based settings. These aims will be achieved by examining implementation among a nationally representative sample of community agencies (n=60) that have been trained to conduct the SHIELD intervention. Telephone interviews will be conducted with the Organization Leaders (i.e. Executive Directors) of agencies to assess stages of implementation of SHIELD and multi-level features associated with implementation as well as barriers and facilitators. An analysis of the costs associated with participation in the SHIELD intervention will also be assessed.

描述（由申请人提供）：艾滋病毒流行三十年了，它仍然是一个主要的公共卫生问题。许多行为干预措施已被证明可以有效地改变受控研究环境中的危险行为。作为联邦举措的一部分，例如 CDC 的有效行为干预措施扩散和 SAMHSA 的国家有效项目和实践登记处，也加大了将循证干预措施 (EBI) 从研究转向实践的努力。有限的研究考察了这些干预措施的实施过程，特别是社区环境中的同伴教育干预措施。重要的是要了解哪些干预措施可以在现实环境中有效且经济有效地实施 EBI。直到我职业生涯的这一点，我的研究重点是确定社会环境（特别是社交网络）中艾滋病毒的风险和保护因素。此外，我还开发并评估了针对高危人群的行为干预措施。我的长期职业目标是与社区机构合作，开发和传播具有成本效益的可持续干预措施，并研究其实施过程。我的短期目标（在导师科学家 K01 申请中讨论）是获得 1) 传播和实施科学的理论、研究设计和方法方面的指导、知识和实践经验，以确定传播和研究科学的策略在现实环境中实施循证干预措施； 2) 社区参与研究，与社区机构合作制定、传播和实施干预措施； 3）经济评估方法来评估实施干预措施的成本。我的培训目标是 1) 获得指导社区环境中行为干预措施传播和实施的实证文献和理论/框架的背景。 2) 获得方法方面的技能和知识，例如研究设计、测量和数据收集，以研究社区环境中干预措施的实施。 3) 获取社区参与研究的理论和方法的知识和应用，并发展社区伙伴关系以传播和实施干预措施。 4) 精通对社区环境中实施行为干预所需成本的经济评估。这些目标将通过导师会议、课程作业和教程、网络研讨会/研讨会、定向阅读、会议和期刊俱乐部来实现。由于获得了这一职业发展奖，我将成为一名独立研究员，通过与社区机构合作开发和传播艾滋病毒预防干预措施，并在实际环境中实施。拟议的研究项目将重点关注针对前吸毒者和当前吸毒者的同伴教育干预（神盾局干预），该干预已由疾病预防控制中心在全国范围内传播。具体目标是 1) 检查与基于社交网络的同伴教育干预措施（神盾局干预措施）实施阶段相关的组织、提供者/员工和干预因素； 2）调查障碍与促进因素之间的关系以及实施阶段，并探索克服实施障碍的策略； 3) 对与在社区环境中实施同伴教育干预相关的机构和客户成本进行分析。这些目标将通过检查具有全国代表性的社区机构样本（n = 60）的实施情况来实现，这些机构已接受过执行 SHIELD 干预的培训。将与各机构的组织领导（即执行董事）进行电话访谈，以评估 SHIELD 的实施阶段和与实施相关的多层次特征以及障碍和促进因素。还将评估与参与 SHIELD 干预相关的成本分析。