Testing and Texting in Community Health Center Dental Clinics to Diagnose and Prevent HIV Infection

在社区健康中心牙科诊所进行检测和发短信以诊断和预防艾滋病毒感染

• 批准号: 10348536
• 负责人: CURT G BECKWITH
• 金额: $ 34.27万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2023-09-23
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10348536
• 关键词: AIDS prevention; Administrator; Adopted; Adoption; Adult; Appointment; Area; Behavior; Boston; Car Phone; Caring; Cities; Clinic Visits; Cluster randomized trial; Communities; County; Data; Dental; Dental Care; Dental Clinics; Dental Offices; Dentists; Development; Diagnosis; Ensure; Epidemic; Ethnic group; Focus Groups; Fostering; Geography; Goals; HIV; HIV Infections; HIV risk; Healthcare; Human immunodeficiency virus test; Incidence; Infection; Injecting drug user; Intervention; Interview; Mediator of activation protein; Minority Groups; Modeling; Neighborhood Health Center; Newly Diagnosed; Ownership; Patients; Persons; Phase; Play; Population; Populations at Risk; Prevention; Procedures; Provider; Qualitative Research; Race; Randomized Clinical Trials; Randomized Controlled Trials; Research; Risk; Risk Behaviors; Risk Reduction; Role; Site; System; Testing; Text Messaging; Textiles; Time; Training; Work; cohort; comparative efficacy; cost; cost efficient; effective intervention; ethnic minority population; experience; high risk; intervention effect; men who have sex with men; pre-exposure prophylaxis; prevent; prevention service; programs; racial minority; rapid testing; response; satisfaction; social cognitive theory; socioeconomics; success; tailored messaging; testing uptake; text messaging intervention; therapy design; trial comparing; trial design; uptake; AIDS prevention; Administrator; Adopted; Adoption; Adult; Appointment; Area; Behavior; Boston; Car Phone; Caring; Cities; Clinic Visits; Cluster randomized trial; Communities; County; Data; Dental; Dental Care; Dental Clinics; Dental Offices; Dentists; Development; Diagnosis; Ensure; Epidemic; Ethnic group; Focus Groups; Fostering; Geography; Goals; HIV; HIV Infections; HIV risk; Healthcare; Human immunodeficiency virus test; Incidence; Infection; Injecting drug user; Intervention; Interview; Mediator of activation protein; Minority Groups; Modeling; Neighborhood Health Center; Newly Diagnosed; Ownership; Patients; Persons; Phase; Play; Population; Populations at Risk; Prevention; Procedures; Provider; Qualitative Research; Race; Randomized Clinical Trials; Randomized Controlled Trials; Research; Risk; Risk Behaviors; Risk Reduction; Role; Site; System; Testing; Text Messaging; Textiles; Time; Training; Work; cohort; comparative efficacy; cost; cost efficient; effective intervention; ethnic minority population; experience; high risk; intervention effect; men who have sex with men; pre-exposure prophylaxis; prevent; prevention service; programs; racial minority; rapid testing; response; satisfaction; social cognitive theory; socioeconomics; success; tailored messaging; testing uptake; text messaging intervention; therapy design; trial comparing; trial design; uptake

Abstract Dentists can play an important role in the Ending the HIV Epidemic initiative by providing access to HIV testing and facilitating access to HIV prevention services for at-risk populations in geographic hotspots, thus decreasing the incidence of HIV infection. To enhance Diagnosis, we propose to investigate incorporating routine on-site rapid HIV testing into the community health center dental clinics to increase HIV testing rates. To expand the delivery of HIV Prevention services in the dental clinic setting, we will test a patient-level text message (TM) intervention designed to decrease risk in those at high risk for HIV infection. In the developmental UG3 phase, we will conduct qualitative research with CHC dental clinic patients, CHC dental providers and dental teams to gain perspectives and explore facilitators, barriers, and acceptability of integrating rapid HIV testing and TM-delivered prevention into dental clinic visits. This data will be used to tailor the final interventions which will then be pilot tested. This formative work will facilitate intervention adoption and success. In the UH3 trial phase, four CHC dental clinics in a designated geographic hotspot for HIV infection, Suffolk County, MA, will participate in a cluster randomized trial comparing the efficacy of on-site rapid HIV testing delivered in the dental clinic (intervention) to referral for HIV testing by a dental provider (control). When that trial ends, a second RCT among dental clinic patients at high risk for HIV infection will determine the efficacy of a text messaging intervention in increasing repeat testing and reducing HIV risk behaviors. The UG3 Specific Aims are: 1. Investigate barriers and facilitators to on-site rapid HIV testing in CHC dental clinics by conducting interviews with dental patients (N=32) and dental providers (N=8); and focus groups with dental teams (N=4); 2. Develop and implement comprehensive training on rapid HIV testing for dental providers; 3. Develop and program the TM intervention, including content, and TM user and interactivity features to increase user appeal and engagement, by conducting qualitative interviews with dental patients (N=32); 4. Conduct pilot testing of rapid HIV testing (n=1 CHC) and referral for HIV testing (n=1 CHC); 5. Conduct pilot testing of the TM intervention among dental clinic patients (N=20). The UH3 Specific Aims are: 1.Conduct a cluster randomized trial among four CHC dental clinics to determine the efficacy of on-site rapid HIV testing in increasing HIV testing rates compared to referral within the CHC; 2. Determine changes in the dental clinic HIV testing rates over time to assess intervention sustainability; 3.Conduct a randomized clinical trial among dental clinic patients (N=266) at increased risk of HIV infection to determine if the dental clinic-delivered TM increases utilization of HIV prevention services including repeat HIV testing, PrEP uptake, and HIV risk reduction compared to a control TM condition; 4. Assess the mechanisms through which the intervention effects occur (mediators).

抽象的 牙医可以通过提供对艾滋病毒测试的访问来结束艾滋病毒流行倡议的重要作用 并促进地理热点中处于危险人群的艾滋病毒预防服务，因此 降低HIV感染的发生率。为了增强诊断，我们建议调查合并 常规现场快速HIV测试进入社区健康中心牙科诊所，以提高HIV测试率。 为了扩大牙科诊所环境中艾滋病毒预防服务的交付，我们将测试患者级文本 消息（TM）干预措施旨在降低患有艾滋病毒感染的高风险的风险。在 发展性UG3阶段，我们将向CHC牙科诊所患者进行定性研究 提供者和牙科团队获得观点并探索促进者，障碍和可接受性 将快速的HIV测试和TM传递的预防整合到牙科诊所就诊中。这些数据将用于量身定制 然后将进行试点测试的最终干预措施。这项形成性工作将有助于采用干预措施，并 成功。在UH3试验阶段，在指定的用于HIV感染的地理热点中的四个CHC牙科诊所， 马萨诸塞州萨福克县将参加一项群集随机试验，比较现场快速HIV的功效 在牙科诊所（干预措施）中进行的测试由牙科提供者转诊（控制）。什么时候 该试验结束了，牙科诊所患者的牙科诊所患者中第二次RCT将确定 文本消息干预在增加重复测试和降低艾滋病毒风险行为方面的功效。 UG3的特定目的是：1。调查CHC牙科中现场快速HIV测试的障碍和促进因子 通过对牙科患者进行访谈（n = 32）和牙科提供者（n = 8）来进行诊所；和焦点小组与 牙科团队（n = 4）; 2。开发和实施有关牙齿快速艾滋病毒测试的全面培训 提供者； 3。开发和编程TM干预，包括内容以及TM用户和交互性 通过与牙科患者进行定性访谈，以提高用户吸引力和参与度 （n = 32）; 4。进行快速HIV测试（N = 1 CHC）和HIV检测转诊（n = 1 CHC）的试点测试； 5。 在牙科诊所患者中对TM干预进行试点测试（n = 20）。 UH3的特定目的是：1。在四个CHC牙科诊所中的集群随机试验到 与内部的推荐相比 CHC; 2。确定随时间推移牙科诊所HIV测试率的变化以评估干预措施 可持续性； 3.牙科诊所患者的随机临床试验（n = 266），风险增加 HIV感染以确定牙科诊所提供的TM是否增加了HIV预防服务的利用率 与对照TM条件相比，包括重复的HIV测试，PREP摄取和HIV风险降低； 4。 评估干预效果发生的机制（调解人）。