Identifying Community-Informed DoxyPEP Implementation Strategies to Guide Equitable Delivery of Syphilis Prevention

确定社区知情的 DoxyPEP 实施策略，以指导公平地提供梅毒预防

• 批准号: 10727777
• 负责人: Moira McNulty
• 金额: $ 22.46万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-24 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10727777
• 关键词: Address; Adoption; Affect; Antibiotics; Attitude; Behavior; Black Populations; Black race; Characteristics; Chicago; Clinic; Communities; Community Health; Consolidated Framework for Implementation Research; Contact Tracing; Data; Development; Doxycycline; Early identification; Education; Eligibility Determination; Ensure; Epidemic; Equity; Evidence based intervention; Face; Future; HIV; Health; Health Priorities; Health Services; Health Status; Health system; Hispanic; Illinois; Individual; Inequity; Infection; Interview; Knowledge; Latinx; Latinx population; Locales; Methods; Modeling; Morbidity - disease rate; Motivation; Patient Preferences; Patients; Population; Prevention; Prevention strategy; Prophylactic treatment; Provider; Public Health; Qualitative Methods; Research; Self Efficacy; Sex Behavior; Sexual Health; Sexual and Gender Minorities; Structure; Surveys; Syphilis; Testing; United States; Work; behavior change; burden of illness; effectiveness evaluation; experience; gender minority group; health equity; implementation barriers; implementation framework; implementation research; implementation science; implementation strategy; innovation; interest; men; men who have sex with men; novel; oral HIV; patient population; people of color; pre-exposure prophylaxis; pressure; prevent; provider-level barriers; research study; response; service delivery; sex; social; stem; syndemic; tool; transgender women; transgender women who have sex with men; transmission process; uptake

Project Summary/Abstract In this R21 proposal, we will use implementation science approaches to study delivery of equitable syphilis prevention, doxycycline post-exposure prophylaxis (doxyPEP), in a clinic-based setting. Innovative strategies for syphilis prevention are needed to address the growing national epidemic, with disproportionate burden of disease among Black and Hispanic/Latinx sexual and gender minority persons (SGM) who have sex with men. In Chicago specifically, syphilis rates have been rising steadily, syndemic with HIV transmission. Existing public health responses – contact tracing, testing, and treatment – have not stemmed these rising rates. Recent data show that doxycycline, taken after sexual activity, is very effective at prevention of syphilis for those who may be exposed. As an emerging evidence-based intervention, key implementation information is needed to ensure equitable delivery of doxyPEP to maximize impact on the syphilis epidemic. As has been recognized with other biomedical prevention tools such as HIV pre-exposure prophylaxis, early identification of barriers to delivery is imperative. The proposed study will address gaps in doxyPEP delivery using implementation frameworks in partnership with an SGM-focused health system in Chicago, Illinois, to meet the following aims: 1) Assess determinants of doxyPEP use at the patient, provider and health system levels; 2) Identify and select community- informed implementation strategies to support doxyPEP use among populations most affected by the syphilis epidemic; and 3) Develop and evaluate acceptability, feasibility, and appropriateness of a doxyPEP implementation strategy package among patients, providers, and health systems stakeholders. Our mixed methods approach will be rooted in the Consolidated Framework for Implementation Research (CFIR) and the Capability, Opportunity, and Motivation Model of Behavior (COM-B), incorporating qualitative methods and conjoint analysis approaches, to identify important determinants of doxyPEP service delivery. The proposed research will result in implementation strategies to guide equitable use of doxycycline post-exposure prophylaxis among populations most impacted by syphilis.

项目摘要/摘要 在此R21提案中，我们将使用实施科学方法来研究公平的梅毒的交付 在基于诊所的环境中，预防，强力霉素后预防后预防（DOXYPEP）。创新策略 需要预防梅毒来解决日益增长的民族流行病，疾病的烧伤不成比例 在黑人和西班牙裔/拉丁裔性少数族裔（SGM）中，与男人发生性关系。在 芝加哥特别是，梅毒率一直在稳步上升，与HIV传播有关。现有的公众 健康反应 - 接触跟踪，测试和治疗 - 尚未阻止这些上升的率。最新数据 证明在性活动之后采取的强力霉素在预防梅毒方面非常有效 裸露。作为新兴的循证干预，需要关键的实施信息以确保 公平的doxyPep递送以最大程度地影响梅毒流行。正如其他人所认可的 生物医学预防工具，例如艾滋病毒预防前预防，早期鉴定出传递障碍的是 至关重要的。拟议的研究将使用实施框架来解决DoxyPep交付的差距 与伊利诺伊州芝加哥市以SGM为重点的卫生系统的合作伙伴关系，以实现以下目的：1）评估 确定患者，提供者和卫生系统水平的DoxyPEP使用； 2）识别并选择社区 - 知情的实施策略，以支持梅毒影响最大的人群中的DoxyPep使用 流行性; 3）开发和评估DoxyPep的可接受性，可行性和适当性 患者，提供者和卫生系统利益相关者之间的实施策略包。我们的混合 方法方法将植根于实施研究的合并框架（CFIR）和 行为的能力，机会和动机模型（COM-B），结合定性方法和 联合分析方法，以确定DoXypep服务交付的重要决定符。提议 研究将导致实施策略，以指导强力霉素后的暴露后预防使用 在受梅毒影响最大的人群中。