Community-Engaged Structural Approaches to Prevent Violence and Improve HIV Prevention and Care Outcomes Among Trans Women of Color

社区参与的结构性方法，以防止有色人种跨性别女性的暴力并改善艾滋病毒预防和护理结果

• 批准号: 10693570
• 负责人: Sarah Peitzmeier
• 金额: $ 17.91万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-01 至 2027-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10693570
• 关键词: AIDS prevention; Academy; Address; Affect; Applications Grants; Automobile Driving; Behavior; Behavior Therapy; Biosocial; Black race; Caring; Collaborations; Communities; Data; Diagnosis; Economics; Epidemic; Equity; Ethnography; Evaluation; Explosion; Focus Groups; Funding; Future; HIV; HIV disparities; Health; Homelessness; Housing; Hybrids; Imprisonment; Individual; Inequity; Intervention; Intervention Studies; Intervention Trial; Interview; Investments; Israel; Knowledge; Latina; Learning; Maps; Mental Health; Mental health promotion; Mentors; Mentorship; Michigan; National Institute of Mental Health; Nature; Needs Assessment; Observational Study; Personal Satisfaction; Population; Poverty; Process; Protocols documentation; Public Health Schools; Reporting; Research; Research Personnel; Resource Sharing; Resources; Risk; School Nursing; Science; Scientist; Sexism; Structure; Time; Training; Training Activity; Training Support; United States National Institutes of Health; Universities; Violence; Woman; Work; Writing; behavior change; care outcomes; career; community based participatory research; community partnership; design; efficacy/implementation trial; empowerment; experience; food insecurity; gender affirmation; gender-based violence; implementation science; improved; informant; innovation; intimate partner violence; pilot trial; prevent; professor; programs; racial disparity; racism; scale up; service providers; sex; skills; social stigma; structural determinants; structural health determinants; syndemic; theories; therapy design; transgender; transgender women; trauma symptom; trial design; violence prevention; women of color

PROJECT ABSTRACT This K01 application to NIMH will enable a concentrated four-year intensive training and mentored research program designed to transition Dr. Sarah Peitzmeier from her current observational research focus to a new research agenda designing and evaluating structural interventions within a community-based participatory research (CBPR) context for integrated HIV and violence prevention and mental health promotion, in partnership with trans women of color. Dr. Peitzmeier is an assistant professor at the University of Michigan School of Nursing and School of Public Health, which houses one of the oldest CBPR partnerships and academies nationally (the Detroit Urban Research Center) and is a powerhouse of HIV intervention research. Racism, sexism, HIV stigma, cisgenderism, and other interlocking forms of oppression generate mutually reinforcing structural vulnerabilities for trans women of color, including gender-based violence (GBV), poverty, homelessness, and sex work. These structural vulnerabilities synergistically interact to elevate risk of HIV. However, interventions to address these deeply entrenched upstream structural determinants of HIV in this population are limited, which in turn limits the efficacy of downstream individual behavioral interventions while these determinants remain intact. The proposed work will 1) Identify community priorities for a structural intervention for integrated HIV/GBV prevention through forming a CBPR partnership with trans women of color and service providers in Detroit and conducting an Action-Oriented Community Diagnosis, 2) Develop a grounded theory of how trans women's participation in a cash-plus cash transfer intervention affects their experience of GBV, HIV-related behaviors, and mental health, and 3) Collaboratively design a status-neutral intervention to promote HIV prevention and care, reduce mental health burden, and prevent GBV against trans women of color. The research will be underpinned by coursework in CBPR, structural interventions, intervention trial design, and implementation science, as well as invaluable mentored learning experiences observing the implementation and evaluation of diverse structural interventions (Drs. Darbes, Sherman, Gamarel, and Pettifor) and CBPR partnerships (Gamarel, Israel, Brush, Rivera) from renowned experts in the field. Overall, the research will generate rich preliminary data, a finalized intervention protocol, a concrete strategy for funding and implementing the intervention, a pilot hybrid efficacy-implementation trial design for evaluating the intervention, and a strong CBPR partnership as a fruitful platform for Dr. Peitzmeier's ongoing research agenda in partnership with this community. By supporting didactic and field-based learning and protected time for research and CBPR partnership building, a K01 will advance Dr. Peitzmeier's career progression as an independent, community-based HIV intervention scientist focused on structural determinants of health, leading to better health and wellbeing among trans women of color, an NIH priority population.

项目摘要 NIMH 的 K01 申请将实现为期四年的集中强化培训和指导 旨在将 Sarah Peitzmeier 博士从目前的观察性研究重点转向 一个新的研究议程，设计和评估基于社区的结构性干预措施 综合艾滋病毒和暴力预防以及心理健康促进的参与性研究（CBPR）背景， 与有色人种跨性别女性合作。 Peitzmeier 博士是密歇根大学助理教授 护理学院和公共卫生学院，是最古老的 CBPR 合作伙伴之一， 全国科学院（底特律城市研究中心），是艾滋病毒干预研究的动力中心。 种族主义、性别歧视、艾滋病毒耻辱、顺性别主义和其他相互关联的压迫形式产生 有色人种跨性别女性相互强化的结构性脆弱性，包括基于性别的暴力（GBV）， 贫困、无家可归和性工作。这些结构性漏洞协同相互作用，提高了风险 艾滋病病毒。然而，针对这些根深蒂固的艾滋病毒上游结构性决定因素的干预措施 这个群体是有限的，这反过来又限制了下游个体行为干预的有效性 而这些决定因素则保持不变。拟议的工作将 1) 确定结构性社区的优先事项 通过与有色人种跨性别女性建立 CBPR 伙伴关系，对 HIV/GBV 进行综合预防干预 和底特律的服务提供商进行以行动为导向的社区诊断，2) 制定 关于跨性别女性参与现金加现金转移干预如何影响她们的扎根理论 GBV、HIV 相关行为和心理健康的经验，以及 3) 协作设计一个状态中立的 促进艾滋病毒预防和护理、减轻心理健康负担、预防跨性别者的性别暴力的干预措施 有色人种的女性。 该研究将以 CBPR、结构干预、干预试验等课程为基础 设计和实施科学，以及宝贵的指导学习经验观察 各种结构性干预措施的实施和评估（Drs. Darbes、Sherman、Gamarel 和 Pettifor）和 CBPR 合作伙伴关系（Gamarel、Israel、Brush、Rivera）由该领域的知名专家组成。全面的， 该研究将产生丰富的初步数据、最终的干预方案、具体的策略 资助并实施干预措施，这是一项试点混合功效实施试验设计，用于评估 干预以及强大的 CBPR 伙伴关系作为 Peitzmeier 博士正在进行的研究议程的富有成果的平台 与该社区合作。通过支持教学和实地学习以及受保护的时间 研究和 CBPR 合作伙伴关系建设，K01 将推动 Peitzmeier 博士作为一名 独立的、以社区为基础的艾滋病毒干预科学家，专注于健康的结构性决定因素，领先 改善跨性别有色人种女性的健康和福祉，这是 NIH 的重点人群。