Health Coaching to Improve Comprehensive HIV and Sexually Transmitted Infection Prevention in Adolescent Primary Care

健康指导改善青少年初级保健中艾滋病毒和性传播感染的综合预防

基本信息

批准号：
10078286
负责人：
Sarah Marian Wood
金额：
$ 18.49万
依托单位：
CHILDREN'S HOSP OF PHILADELPHIA
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-01-01 至 2024-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10078286
关键词：
18 year old AIDS prevention Acquired Immunodeficiency Syndrome Address Adherence Adolescent Adolescent and Young Adult Advisory Committees Affect Age Applied Research Area Award Behavior Therapy Behavioral Behavioral Model Childhood Clinical Trials Clinical Trials Design Complement Consolidated Framework for Implementation Research Counseling Data Development Diagnosis Ensure Epidemic Focus Groups Goals Guidelines HIV HIV Infections Health Health Care Costs Health Services Health system Hybrids Incidence Individual Intervention Interview Licensure Measurement Mental Depression Mental Health Mentors Mentorship Methodology Modeling National Institute of Mental Health Patients Plant Roots Population Positioning Attribute Postdoctoral Fellow Pragmatic clinical trial Prevention Prevention approach Preventive service Primary Health Care Process Provider Public Health Qualitative Methods Randomized Controlled Trials Recording of previous events Research Research Methodology Research Personnel Research Training Risk Risk Reduction STI prevention Science Scientist Self Efficacy Self Management Sexual Health Sexually Transmitted Diseases Structure Techniques Tenofovir Testing Time Training Training Programs United States United States Food and Drug Administration Wood material Youth acceptability and feasibility adolescent HIV prevention adolescent sexual health aged base behavior change biobehavior care delivery care providers career career development comorbidity comparative efficacy comparison intervention effectiveness implementation study effectiveness implementation trial effectiveness-implementation randomized trial emtricitabine evidence base health care delivery health care service utilization high risk high-risk adolescents implementation research implementation science implementation strategy improved infection rate innovation intervention effect motivated behavior motivational enhancement therapy patient oriented pediatric health outcomes pragmatic trial pre-exposure prophylaxis prevent prevention service preventive intervention programs scale up screening sexual HIV transmission sexual health intervention standard of care theories therapy development tool trial design uptake

项目摘要

PROJECT SUMMARY/ABSTRACT In the United States, HIV and sexually transmitted infections (STIs) disproportionately affect adolescents and young adults (AYA). Youth aged 13-24 years comprise ~21% of incident HIV cases. In addition, 2017 data demonstrated the fourth consecutive year of increasing STI rates, with the highest incidence occurring in AYA. Amidst these public health challenges, the 2018 licensure of tenofovir-emtricitabine as HIV pre-exposure prophylaxis (PrEP) for adolescents presents a key opportunity for enhancing youth HIV and STI prevention services. Currently, <2% of U.S. PrEP prescriptions are for adolescents <18 years of age. Pediatric primary care providers (PCPs) are thus well-positioned to expand PrEP delivery. However, sexual health service delivery in primary care is hampered by PCP time constraints and competing demands. There is a critical need for both behavioral interventions to increase PrEP uptake and reduce STIs in adolescents, and implementation strategies to disseminate PrEP and enhanced sexual health services in adolescent primary care. The goal of this K23 application is to facilitate Dr. Sarah M. Wood’s long-term goal of becoming an independent investigator in adolescent HIV and STI prevention through an integrated program of training and applied research that will prepare her to meet the challenges of the current HIV and STI epidemics. This award will also focus on her short-term goal of gaining the methodologic expertise needed to adapt, optimize for implementation, and test, a developmentally-tailored, PrEP-inclusive, HIV/STI prevention health coaching intervention for adolescents in primary care. The training objectives focus on content areas where she currently lacks the methodologic expertise to carry out this goal: 1) bio-behavioral intervention adaptation, 2) implementation science, and 3) clinical trial methodology. This training plan will be bolstered by a highly skilled mentorship team with expertise in intervention development, adolescent sexual health and qualitative methodology, and primary care pragmatic clinical trials. The advisory team will provide further expertise in developmental tailoring, prevention science, implementation science, mental health measurement and targets, and clinical trial design and analysis. Dr. Wood’s training objectives will progress in parallel with, and inform, her applied research aims. Aim 1 will use qualitative methods and the ADAPT-ITT framework to adapt the health coaching intervention. Aim 2 will determine acceptability and feasibility of the intervention among primary care providers, and develop an optimized primary care implementation strategy for the intervention. Finally, Aim 3 will conduct a small randomized controlled trial to test the intervention for change in prevention self-efficacy, as well as acceptability and feasibility and in adolescents with a history of STI. The culmination of Dr. Wood’s research and training will be the submission of a R01 application for a type I hybrid randomized effectiveness-implementation trial of the health coaching intervention.

项目摘要/摘要在美国，艾滋病毒和性传播感染（性传播感染）不受欢迎的影响影响青少年和年轻人（AYA）。证明了STI率提高的第四个奉献年份，AYA发病率最高。在这些公共卫生Challlenges之中青少年的预防（准备）为增强青年艾滋病毒和STI预防提供了一个关键机会服务目前，美国的预期<2％是针对18岁的青少年。因此，提供者（PCP）适当地扩展了准备疗法。初级保健受到PCP时间限制和竞争需求的阻碍。行为干预措施以增加预备摄取并减少青少年的性病，并插入策略在青少年的初级保健中传播准备和增强性健康服务。应用是为了促进莎拉·伍德博士的长期目标，即成为依赖的独立者青少年的艾滋病毒和STI生产是一项综合的培训和应用研究计划，该计划将遗嘱。为她准备应对当前的艾滋病毒和STI流行病的挑战。获得适应，优化暗示所需的方法专业知识的短期目标，并测试是一种开发量，包括预科，艾滋病毒/STI预防健康教练干预初级保健的青少年。实现此目标的方法论专业知识：1）生物行为干预适应，2）实施科学和3）临床试验方法。随着专业知识的干预发展，青少年性健康和定性方法论以及主要护理务实的临床试验。预防科学，实施科学，心理健康测量和目标以及临床试验设计和分析。 AIM 1将使用定性方法和适应性-ITT框架来进行健康工作 2将确定初级保健提供者之间干预措施的可接受性和可行性，并开发ANN 优化干预的初级保健实施策略。随机对照试验以测试预防自我效能的变化的干预措施和盛宴，在有STI历史的青少年中。作为I型混合随机有效性实施试验的R01申请的提交健康教练干预。