Adaptation of a PrEP Shared-Decision Making Tool for Family Planning Clinics

计划生育诊所 PrEP 共享决策工具的改编

• 批准号: 10613804
• 负责人: Katherine M Anderson
• 金额: $ 4.77万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-01 至 2026-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10613804
• 关键词: AIDS prevention; Address; Adherence; Adult; Area; Awareness; Behavioral; Belief; Black race; Caliber; Caring; Child; Client; Clinic; Clinical; Communication; Counseling; County; Decision Making; Development; Environment; Epidemic; Evaluation; Family Planning; Female; Focus Groups; Fumarates; Funding; Future; Goals; Grant; HIV; HIV Infections; HIV diagnosis; HIV risk; Health Personnel; Healthcare; Heterosexuals; Information Dissemination; Injectable; Intervention; Interview; Knowledge; Latinx; Measurement; Medical; Mentors; Mentorship; Method Acceptability; Methodology; Methods; Modality; Modeling; National Institute of Mental Health; Oral; Organizational Decision Making; Pathway interactions; Patient Preferences; Patients; Physician' s Role; Populations at Risk; Postdoctoral Fellow; Prevention; Prevention Research; Process; Provider; Quality of life; Regimen; Research; Research Personnel; Resources; Risk; Risk Factors; Sales; Services; Sexual Health; Side; Strategic Planning; Techniques; Tenofovir; Testing; Training; Training Support; Trauma; United States National Institutes of Health; Universities; Woman; Women' s Health; Work; World Health Organization; acceptability and feasibility; anxiety reduction; career; cis-female; cisgender; effectiveness/implementation trial; empowerment; emtricitabine; ethnic diversity; evidence base; experience; feasibility testing; human centered design; implementation facilitators; implementation science; improved; infection rate; interest; male; medication compliance; novel; patient-level barriers; pilot test; pre-exposure prophylaxis; preference; prevention practice; prevention service; provider-level barriers; racial diversity; research and development; satisfaction; scaffold; shared decision making; skills; social stigma; tool; training opportunity; transmission process; uptake; willingness; women of color

PROJECT SUMMARY/ABSTRACT Cisgender women account for ~20% of new HIV infections in the US, and are systematically under-accessed for HIV prevention. The intersection of patient-side barriers (lack of patient knowledge, perceived risk, and medical mistrust), and provider-side barriers (lack of knowledge, discomfort with prevention counseling, and bias) impacts uptake of novel HIV prevention methods, such as available and forthcoming methods of pre-ex- posure prophylaxis (PrEP) for HIV (oral, injectable, etc.). To address these barriers, the trainee (Ms. Anderson) will adapt a family planning (FP) shared decision-making (SDM) tool for use in HIV prevention counseling. SDM involves introducing choice, describing options, and exploring patient preferences to aid in health care decisions, while empowering women, decreasing provider bias, increasing satisfaction with care, and increas- ing adherence to care regimens. The adapted tool will be tested for acceptability/feasibility with providers and clients at Title X federally-funded FP clinics, a high-reach setting for women at risk for HIV from heterosexual contact. Guided by the ADAPT-ITT framework for adaptation, the specific aims are to (1) assess the utility of SDM practices for HIV prevention and barriers/facilitators to implementation, through (a) focus groups with Title X providers in Metro Atlanta (K=4, N=32) and (b) theater testing interviews with racially/ethnically diverse cis- gender adult Title X clients (N=40); (2) adapt the evidence-based World Health Organization (WHO) Decision- Making Tool for FP Clients and Providers for HIV prevention; and, (3) conduct mixed-method acceptability/fea- sibility testing of the adapted SDM tool with Title X providers (N=40) and clients (N=40). This study will result in an acceptable and feasible HIV prevention SDM tool for use with cisgender women attending FP clinics, to be further tested and disseminated to promote HIV prevention among women, advancing efforts to end the HIV epidemic. Additionally, this work will support the training of Ms. Anderson, who is committed to becoming a high caliber, NIH-funded researcher in HIV prevention and treatment, and improvement of care interactions. Ms. Anderson’s 3-year training plan includes: (1) formally developing methodological skills in implementation science and human-centered design, (2) advancing understanding of the context of clinical HIV prevention, including biomedical prevention and clinical interactions, and (3) developing skills in the areas of measurement and evaluation of interventions and interventional pathways. The team of mentors, Drs. Sales (Primary Spon- sor), Sheth (Co-Sponsor), and Kottke (Expert Advisor), will provide oversight, guidance, and mentorship to Ms. Anderson during the course of her training, in the topic areas of implementation science, HIV prevention, clini- cal interactions, and intervention evaluation. Ms. Anderson will leverage resources at Emory University, includ- ing the Network for Evaluation and Implementation Sciences, the Network for Evaluation and Implementation Science, the Women and Children’s Center, and the Prevention Research Center. The candidate, mentorship team, and the environment are extremely well situated to achieve the proposed research and training aims.

项目摘要/摘要 Cisgender妇女占美国新艾滋病毒感染的约20％，并且系统不足 预防艾滋病毒。患者侧障碍的交集（缺乏患者知识，感知风险和 医疗不信任）和提供商侧障碍（缺乏知识，预防咨询不​​适以及 偏见）影响了新型HIV预防方法的摄取，例如可用的和即将到来的前EX- 艾滋病毒（口服，注射等）的预防姿势（PREP）。为了解决这些障碍，学员（安德森女士） 将调整计划生育（FP）共享决策（SDM）工具，用于预防艾滋病毒咨询。 SDM涉及引入选择，描述选项并探索患者偏好以帮助医疗保健 决策，同时赋予妇女权力，减少提供商的偏见，增加对护理的满意度，并增加 遵守护理方案。适用的工具将经过测试，以确保提供者的可接受性/可行性 Title X Federally资助的FP Clinics的客户，这是一个高度远处的环境 接触。在适应适应框架的指导下，具体目的是（1）评估效用 SDM预防HIV和障碍/促进者实施的SDM实践，通过（a）焦点小组具有标题 亚特兰大大都会（K = 4，n = 32）的X提供商和（b）戏剧测试对种族/种族多样的顺便 性别成人标题X客户（n = 40）; （2）调整基于证据的世界卫生组织（WHO）决策 - 为FP客户和预防艾滋病毒的提供者制作工具； （3）进行混合方法可接受性/FEA- 使用标题X提供商（n = 40）和客户端（n = 40）的改编的SDM工具的可及性测试。这项研究将导致 可接受且可行的HIV预防SDM工具，可与Cisgender妇女一起参加FP诊所 进一步测试和传播以促进妇女预防艾滋病毒的预防，促进结束艾滋病毒的努力 流行性。此外，这项工作将支持安德森女士的培训，他致力于成为 高素质，NIH资助的HIV预防和治疗研究人员，以及改善护理相互作用。 安德森女士的三年培训计划包括：（1）正式发展实施方法学技能 以科学和人为中心的设计，（2）促进对预防临床HIV的背景的理解， 包括生物医学预防和临床相互作用，以及（3）在测量领域发展技能 以及评估干预措施和介入途径。导师团队，博士。销售（主要的Spon- SOR），Sheth（共同赞助者）和Kottke（专家顾问）将为女士提供监督，指导和精神训练。 安德森在培训期间，在实施科学，艾滋病毒预防，临床方面的主题领域 CAL相互作用和干预评估。安德森女士将利用埃默里大学的资源，包括 - 用于评估和实施科学网络，评估和实施网络 科学，妇女和儿童中心以及预防研究中心。候选人，精神制 团队和环境的位置非常好，可以实现拟议的研究和培训目标。