Adaptation and Implementation of Project Encuentro in the U.S.-Mexico Border

Encuentro 项目在美墨边境的调整和实施

基本信息

批准号：
9129437
负责人：
Julia Lechuga
金额：
$ 44.08万
依托单位：
UNIVERSITY OF TEXAS EL PASO
依托单位国家：
美国
项目类别：
财政年份：
2016
资助国家：
美国
起止时间：
2016-04-05 至 2016-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9129437
关键词：
AIDS prevention Address Affect Area Awareness Behavior Therapy Border Crossings Cities Code Collaborations Communities Country Cross-Sectional Studies Drug usage Drug user Effectiveness Effectiveness of Interventions El Salvador Epidemic Equipment Ethnography Evaluation Event Explosion Face Feedback Fright Goals HIV HIV Infections HIV risk Heroin Human immunodeficiency virus test Immigration Injection of therapeutic agent International Intervention Interview Latino Life Liquid substance Mexico Mission National Institute of Drug Abuse Needle-Exchange Programs Participant Pharmaceutical Preparations Phase Police Prevention Preventive Intervention Process Research Research Personnel Resources Risk Risk Behaviors Risk Reduction Series Side Site Social Environment Social Network Social support Surveys Syringes System Testing Texas Time United States National Institutes of Health Universities Violence Work Workplace base combat community based participatory research community organizations design experience health disparity implementation science informant injection drug use meetings member metropolitan peer networks programs public health relevance response sex social social stigma substance abuse treatment violent crime

项目摘要

DESCRIPTION (provided by applicant): The proposed project is a research collaboration between the University of Texas at El Paso, The Alliance for Border Collaborative and Program Comparers to adapt, implement, and evaluate a multi-level, community-based, HIV prevention intervention (Project Encuentro). The intervention will target active heroin and crack users and consists of increasing access to HIV testing via a social network HIV testing component and reducing sexual and drug use risk via a peer network brief behavioral Intervention. Encuentro also consists of conducting community awareness meeting to target structural factors affecting HIV risk. The intervention was developed in an area severely affected by violence and stigma towards drug users, El Salvador, which makes it particularly suitable for adaptation to meet the needs of drug users living in the proposed intervention site, the U.S.-Mexico border. The proposed intervention site also has been severely affected by violence which has curtailed any prior attempts to reduce the risk drug users' HIV risk. Violence has worsened structural factors which affect HIV risk such as, increasing police persecution and stigma and reducing access to resources. In our proposed project, we will engage in formative research to understand the context of HIV risk of drug users in the border region post violence and adapt the intervention accordingly. Findings will allow us to tailor intervention components to meet the needs of drug users in the region. Subsequently, we propose to test intervention effectiveness and evaluate implementation barriers and facilitators. To accomplish our project aims we will use a mixed qualitative, quantitative approach. We will begin with a formative phase by conducting in-depth interviews with drug users (n = 40) living in the region to understand how the context of drug use risk changed as a result of the violence and will administer a social network survey (n = 200) to characterize the configuration of risk networks. Findings will yield the necessary information to culturally adapt the intervention to meet the needs of drug users in the region and will help us focus our recruitment efforts where the riskiest networks are located. After the intervention is adapted with the help of our community advisory board and our community coalition, we will implement the intervention and will assess the effectiveness and reach via 6 cross-sectional surveys administered to drug users (n=1,200). We will assess the process of implementation by conducting ethnographic field notes of all intervention activities including community engagement and CAB and coalition meetings. We will assess the fidelity and quality of the intervention. Lastly, we will conduct key informant interviews with key stakeholders involved in the project and interviews and observations will be coded to reflect key systems factors related to successful implementation of intervention components in two intervention sites (El Paso, Texas and Ciudad Juarez, Mexico). Findings will be highly significant as we will be conducting parallel research on the effectiveness of interventions shown to be effective in Latino drug users in two very different contexts: El Salvador and the U.S-Mexico border. Findings will elucidate implementation challenges and barriers and such information can then be used to assess the effectiveness of diverse implementation strategies in organizations working to serve the needs of Latino drug users.

描述（由适用提供）：拟议的项目是德克萨斯大学埃尔帕索分校之间的研究合作，即边境协作和计划比较联盟，以适应，实施和评估基于社区的基于社区的HIV预防干预措施（Project encuentro）。干预措施将针对主动的海洛因和破解用户，并包括通过社交网络艾滋病毒测试成分增加对艾滋病毒测试的机会，并通过同行网络简短的行为干预措施来降低性和药物使用风险。 Encuentro还包括进行社区意识会议，以针对影响艾滋病毒风险的结构性因素。该干预措施是在严重影响吸毒者萨尔瓦多（El Salvador）受到暴力和污名化的地区开发的，这使其特别适合适应以满足居住在拟议的干预现场，美国 - 墨西哥边境的吸毒者需求。拟议的干预地点也受到暴力行为的严重影响，这已经削弱了任何以降低吸毒者的艾滋病毒风险的尝试。暴力失去了影响艾滋病毒风险的结构性因素，例如增加警察的迫害和污名，并减少获得资源的机会。在我们提出的项目中，我们将进行形成性研究，以了解暴力事件发生后边境地区吸毒者风险的背景，并适应干预发现将使我们能够量身定制干预组件，以满足该地区的吸毒者的需求。随后，我们建议测试干预效率和评估实施障碍和促进者。为了实现我们的项目目标，我们将使用一种混合定性的定量方法。我们将通过对居住在该地区的吸毒者进行深入访谈（n = 40）的深入访谈开始，以了解暴力的毒品使用风险如何变化，并将管理社交网络调查（n = 200）以表征风险网络的配置。调查结果将产生必要的信息，从而在文化上适应干预措施，以满足该地区吸毒者的需求，并将帮助我们集中在最风险的网络所在的地方招聘工作。在我们的社区顾问委员会和我们的社区联盟的帮助下，我们将实施干预措施后，我们将通过对吸毒者管理的6次横断面调查进行评估（n = 1,200）。我们将通过进行所有干预活动（包括社区参与以及CAB和联盟会议）的民族志现场注释来评估实施过程。我们将评估干预的忠诚度和质量。最后，我们将对参与该项目的主要利益相关者进行关键的线人访谈，并将对访谈和观察进行编码，以反映与两个干预站点中成功实施干预组件有关的关键系统因素（El Paso，Texas，Texas和Ciudad Juarez，Mexico）。调查结果将非常重要，因为我们将对在两个非常不同的背景下对拉丁裔药物有效的干预措施的有效性进行并行研究：El Salvador和U.S-Mexico边境。调查结果将阐明实施挑战和障碍，然后可以使用此类信息来评估潜水员实施策略的有效性，以满足拉丁裔吸毒者需求。