Using Implementation Science to Increase PrEP Uptake among African American Women in the South

利用实施科学提高南方非裔美国妇女对 PrEP 的接受率

基本信息

批准号：
10560539
负责人：
Tiara C. Willie
金额：
$ 11.49万
依托单位：
JOHNS HOPKINS UNIVERSITY
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：
2020-06-22 至 2025-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10560539
关键词：
AIDS prevention Address Adherence Adoption Affect African American Age Award Caring Clinic Clinical Community Healthcare Counseling Data Development Doctor of Philosophy Educational workshop Effectiveness Eligibility Determination Epidemic Epidemiologist Evaluation Face Focus Groups Forcible intercourse Funding Future Goals Grant HIV HIV Infections HIV Seropositivity HIV diagnosis HIV risk High Risk Woman Incidence Infection Interruption Interview Knowledge Manuscripts Mentored Research Scientist Development Award Mentorship Mississippi Neighborhood Health Center Outcome Patients Prevalence Prevention Research Prevention program Prevention strategy Primary Care Principal Investigator Productivity Reach, Effectiveness, Adoption, Implementation, and Maintenance Readiness Recommendation Research Risk Safety Services Testing Time Series Analysis Training United States Health Resources and Services Administration Unsafe Sex Waiting Lists Woman Work Writing acceptability and feasibility care seeking career combat condoms design epidemic preparedness experience implementation framework implementation science implementation study informant innovation interest intimate partner violence novel pilot test pre-exposure prophylaxis prevent preventive intervention programs racial disparity reproductive research study scale up screening service delivery skills symposium therapy development uptake violence exposure violence prevention

项目摘要

Project Summary/Abstract HIV and intimate partner violence (IPV) are intersecting, mutually-reinforcing epidemics that significantly affect African American women, particularly women in the U.S. South. African American women face some of the highest rates of both HIV and IPV among U.S. women, and these burdens are most pronounced in the South. IPV-exposed African American women may experience forced, condomless sex, which increases the risk of HIV acquisition. Pre-exposure prophylaxis (PrEP) is the most innovative HIV prevention strategy, however it remains underutilized by African American women and residents of the South. In order to reduce African American women’s HIV acquisition risk in the South, effective HIV prevention interventions need to concurrently address relationship safety and HIV acquisition risks. The proposed training plan in this Mentored Research Scientist Development Award (K01) application will provide the knowledge and skills that the principal investigator, Tiara C. Willie, PhD, MA needs to launch an independent and productive research career. Further, the proposed research would contribute significantly to PrEP implementation in real-world settings and facilitate PrEP access to African American women in the South. The proposed research aims to address this call via the development, testing, and evaluation of a PrEP Implementation Toolkit for staff in community healthcare clinics in the South. The Toolkit will be evaluated using the Reach, Effectiveness- Adoption, Implementation, Maintenance (RE-AIM). The Toolkit will facilitate PrEP uptake among eligible African American women in the South, especially IPV-exposed women. This K01 project includes formative work (i.e., reach stage), like key informant interviews with staff at partnering clinics (N=10), and six focus groups with African American women. The qualitative data will inform the development of the PrEP Implementation Toolkit. The Toolkit will be employed in two clinics using a nonrandomized waitlist control design. Monthly aggregated clinic data will be collected 8-months before and after Toolkit implementation in each clinic. Toolkit effectiveness will be assessed using interrupted time series analyses and outcomes are changes in PrEP uptake, coverage and retention among African American women. Four focus groups with staff will be conducted to assess adoption, acceptability, and feasibility. 20 qualitative interviews with staff will be conducted to assess fidelity. This project will yield preliminary evidence of a PrEP implementation program for African American women with a focus on IPV. It will also inform future large-scale studies using stepped- wedge designs. The training acquired by Dr. Willie via this timely and novel project, courses, workshops, conferences, manuscript and grant-writing, and mentorship will target 3 training objectives to gain expertise in: (1) HIV prevention research among African American women, (2) intervention development and evaluation, and (3) implementation science in clinics.

项目概要/摘要艾滋病毒和亲密伴侣暴力 (IPV) 是相互交叉、相辅相成的流行病，严重影响非裔美国女性，尤其是美国南部的女性，面临着一些挑战。美国女性的艾滋病毒和 IPV 感染率最高，而这些负担在南方最为明显。接触 IPV 的非洲裔美国女性可能会经历强迫、不戴安全套的性行为，这会增加感染的风险艾滋病毒感染前预防 (PrEP) 是最具创新性的艾滋病毒预防策略，但它非洲裔美国妇女和南方居民的利用仍然不足美国南方女性感染艾滋病毒的风险，需要采取有效的艾滋病毒预防干预措施同时解决关系安全和艾滋病毒感染风险。研究科学家发展奖（K01）申请将提供研究科学家发展奖（K01）所需要的知识和技能首席研究员 Tiara C. Willie 博士、硕士需要开展一项独立且富有成效的研究此外，拟议的研究将极大地促进 PrEP 在现实世界中的实施。拟议的研究旨在促进南方非裔美国妇女获得 PrEP。通过为以下地区的工作人员开发、测试和评估 PrEP 实施工具包来应对这一呼吁：该工具包将使用覆盖范围、有效性进行评估。采用、实施、维护 (RE-AIM) 工具包将促进符合资格的 PrEP 的采用。南方的非裔美国女性，尤其是接触 IPV 的女性，这个 K01 项目包括形成性的项目。工作（即达到阶段），例如与合作诊所工作人员的关键信息访谈（N = 10），以及六个重点定性数据将为 PrEP 的制定提供信息。实施工具包。该工具包将在两个诊所使用，采用非随机等候名单控制。设计中将收集工具包实施前后 8 个月的每月汇总临床数据。每个诊所将使用中断时间序列分析来评估工具包的有效性，并得出结果。非洲裔美国女性 PrEP 接受率、覆盖率和保留率的变化四个焦点小组及其工作人员。将与工作人员进行 20 次定性访谈，以评估其采用、可接受性和可行性。该项目将提供 PrEP 实施计划的初步证据。重点关注 IPV 的非裔美国女性它还将为未来使用阶梯式的大规模研究提供信息。威利博士通过这个及时而新颖的项目、课程、研讨会获得的培训，会议、手稿和资助写作以及指导将针对 3 个培训目标，以获得以下方面的专业知识： (1) 非裔美国妇女的艾滋病毒预防研究，(2) 干预措施的制定和评估， (3)临床实施科学。