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（由申请人提供）：拟议项目是德克萨斯大学埃尔帕索分校、边境合作联盟和项目比较者之间的一项研究合作，旨在调整、实施和评估多层次、基于社区的艾滋病毒预防干预措施（Encuentro 项目）。该干预措施将针对活跃的海洛因和快克吸毒者，包括通过社交网络艾滋病毒检测组件增加艾滋病毒检测的机会，并通过同伴网络减少性行为和吸毒风险。Encuentro 还包括进行简短的行为干预。针对影响艾滋病毒风险的结构性因素召开社区认识会议。该干预措施是在萨尔瓦多受暴力和耻辱严重影响的地区制定的，这使得该干预措施特别适合适应生活在拟议干预措施中的吸毒者的需求。拟议的干预地点也受到暴力的严重影响，这限制了之前降低吸毒者艾滋病毒风险的任何尝试。暴力加剧了影响艾滋病毒风险的结构性因素，例如增加了警察的迫害。和耻辱在我们拟议的项目中，我们将开展形成性研究，以了解暴力事件发生后边境地区吸毒者的艾滋病毒风险背景，并相应地调整干预措施，以满足需求。随后，我们建议测试干预措施的有效性并评估实施障碍和促进因素。为了实现我们的项目目标，我们将采用定性和定量相结合的方法，从形成阶段开始进行深入的研究。对吸毒者的访谈（n = 40）居住在该地区的人员将了解暴力行为导致吸毒风险的背景如何发生变化，并将进行社交网络调查（n = 200）来描述风险网络的配置，调查结果将产生必要的信息，以在文化上适应吸毒风险。干预措施，以满足该地区吸毒者的需求，并将帮助我们将招募工作集中在风险最高的网络所在的地方。在我们的社区咨询委员会和社区联盟的帮助下调整干预措施后，我们将实施干预措施并实施。将通过 6 个横截面评估有效性和影响范围我们将通过对所有干预活动（包括社区参与和 CAB 和联盟会议）进行人种学实地记录来评估实施过程。将与参与该项目的主要利益相关者进行关键知情人访谈，并对访谈和观察进行编码，以反映与两个干预地点（德克萨斯州埃尔帕索和墨西哥华雷斯城）成功实施干预措施相关的关键系统因素。非常重要，因为我们将对萨尔瓦多和美国-墨西哥边境这两个截然不同的环境中的拉丁裔吸毒者的干预措施的有效性进行并行研究，研究结果将阐明实施方面的挑战和障碍，然后这些信息可用于评估。致力于满足拉丁裔吸毒者需求的组织中各种策略的有效性。