Accelerating Equitable PrEP Delivery for Black Adults in Primary Care Settings: Development and Testing of A Practice-Level Multifaceted Implementation Strategy

加快初级保健机构中黑人成人的公平 PrEP 实施：制定和测试实践层面的多方面实施策略

• 批准号: 10761903
• 负责人: Dovie Watson
• 金额: $ 19.49万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-16 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10761903
• 关键词: AIDS prevention; Acceleration; Address; Administrator; Adult; Award; Black Populations; Black race; Board Certification; Caring; Client; Collaborations; Communicable Diseases; Communities; Consolidated Framework for Implementation Research; Continuity of Patient Care; Development; Environment; Epidemic; Equity; Evaluation; Evidence based practice; Foundations; Funding; Gender; Goals; HIV; Heterosexuals; Incidence; Individual; Inequity; Interview; Investments; K-Series Research Career Programs; Knowledge; Leadership; Lesbian Gay Bisexual Transgender Queer; Maps; Measures; Medical; Mentored Patient-Oriented Research Career Development Award; Mentorship; Methods; Modality; National Institute of Mental Health; National Institute on Minority Health and Health Disparities; Outcome; Patients; Philadelphia; Physicians; Population; Positioning Attribute; Preventive service; Provider; Public Health; Qualitative Research; Research; Research Design; Research Methodology; Research Personnel; Research Priority; Resources; Scientist; Sex Orientation; Sexism; Sexual Health; Sexuality; Social Environment; Social Sciences; Surveys; Testing; Training; United States; Work; acceptability and feasibility; arm; behavior change; behavioral and social science; black patient; care outcomes; career; cisgender; community engaged research; design; effectiveness/implementation trial; evidence base; experimental arm; gender diversity; implementation design; implementation determinants; implementation evaluation; implementation science; implementation strategy; improved; innovation; interdisciplinary approach; multidisciplinary; next generation; novel; pilot trial; pleasure; pre-exposure prophylaxis; primary care patient; primary care practice; primary care services; primary care setting; provider behavior; racism; social cognitive theory; social science research; social stigma; theories; trial design

PROJECT SUMMARY/ABSTRACT Substantial measures must be taken in the United States to rectify the marked inequities in HIV pre-exposure prophylaxis (PrEP) outcomes among Black adults. PrEP implementation among Black populations is undermined by individual, interpersonal, and structural barriers rooted in stigma, racism, heterosexism, and sexism. Improving PrEP provision has become imperative as novel modalities emerge. There is an urgent need to develop implementation strategies that accelerate equitable PrEP delivery. The goal of this K23 is to facilitate Dr. Watson’s long-term goal to become an independent investigator focused on the development of implementation strategies to achieve equitable HIV prevention outcomes among Black populations. The proposed K23 will focus on designing and testing a multifaceted implementation strategy to support PrEP provision for Black primary care patients, grounded in an adapted conceptual framework that includes constructs from the Consolidated Framework for Implementation Research (CFIR) and Bandura’s Social Cognitive Theory. Dr. Watson’s proposed research plan will consist of training objectives in (1) qualitative research, (2) behavioral and social science research (BSSR), (3) community-engaged research, and (4) implementation science. With a focus on equity-centered applications within implementation science and community-engaged research, she requires further training in qualitative research, BSSR, and trial design to develop and pilot an implementation strategy to increase local PrEP provision capacity. These training objectives will be achieved through mentorship from an exemplary multidisciplinary mentorship team, complementary research aims, professional development activities, and coursework. Specifically, she plans to: (Aim 1) Identify key provider-, practice-, and community-level CFIR- based determinants of local PrEP delivery; (Aim 2) Develop a theory-informed multifaceted implementation strategy that follows a destigmatizing sexual health framework to accelerate equitable PrEP delivery for adult Black primary care patients; (Aim 3) Conduct a 12-month two-arm pilot trial to evaluate implementation strategy feasibility and acceptability at four medical practices that provide primary care services. The results of this study will be important for the field of implementation science as it focuses on facilitating theory- informed behavior changes among providers and practice leadership to accelerate equitable PrEP provision for Black primary care patients. Findings from the pilot will inform the design and submission of an R01 application for a hybrid effectiveness-implementation trial of the implementation strategy in year 4. The proposal will form a strong foundation for Dr. Watson’s continued development toward an independently funded research career as an implementation scientist invested in the development of implementation strategies to achieve equitable HIV prevention care outcomes among Black adults in the U.S.

项目摘要/摘要 必须在美国采取实质性措施，以纠正艾滋病毒前暴露前的不平等现象 黑人成年人的预防（准备）结果。黑人人群中的准备实施是 受污名，种族主义，异性恋和 性别歧视。随着新型方式的出现，改善的准备准备已成为必要。有紧急 需要制定实施策略，以加速公平的准备交付。这个K23的目标是 促进沃森博士的长期目标，成为一名专注于 制定实施策略以实现黑人的公平艾滋病毒预防结果 人群。拟议的K23将专注于设计和测试多方面的实施策略 支持黑色初级保健患者的准备准备，以适应的概念框架为基础 其中包括来自合并实施研究框架（CFIR）和 班杜拉的社会认知理论。沃森博士提出的研究计划将包括培训目标 （1）定性研究，（2）行为和社会科学研究（BSSR），（3）社区参与 研究，（4）实施科学。专注于以股权为中心的应用程序 实施科学和社区参与研究，她需要进一步的定性培训 研究，BSSR和试用设计，以制定和试行一种实施策略，以增加本地准备 供应能力。这些培训对象将通过示范性的指导来实现 多学科心态团队，互补研究目标，专业发展活动以及 课程。具体来说，她计划：（目标1）确定主要提供商，实践和社区级别的CFIR- 基于本地准备交付的决定者； （AIM 2）开发一个理论上的多方面实现 遵循命运性的性健康框架以加速公平准备交付的策略 成人黑人初级保健患者； （AIM 3）进行12个月的两臂试验试验以评估实施 在提供初级保健服务的四种医疗实践中的可行性和可接受性。结果 这项研究对实施科学领域至关重要，因为它着重于促进理论 - 提供者之间的知情行为变化和实践领导才能加速公平准备条款 对于黑人初级保健患者。飞行员的调查结果将为R01的设计和提交提供信息 第4年实施策略的混合有效性试验申请。 提案将为沃森博士持续发展迈向独立发展的基础 作为实施科学家投资于实施的实施科学家资助的职业 美国黑人成年人实现公平艾滋病毒预防护理结果的策略