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

基本信息

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
项目类别：
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&apos 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&apos 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

项目摘要

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.

项目概要/摘要顺性别女性约占美国新增艾滋病毒感染者的 20%，而且总体上她们的接触机会不足艾滋病毒预防的交叉点是患者方面的障碍（缺乏患者知识、感知风险和医疗不信任）和提供者方面的障碍（缺乏知识、对预防咨询的不适以及偏见）影响了新的艾滋病毒预防方法的采用，例如现有的和即将推出的前预防方法 HIV 暴露预防 (PrEP)（口服、注射等）为了解决这些障碍，学员（安德森女士）。将采用计划生育 (FP) 共享决策 (SDM) 工具用于艾滋病毒预防咨询。 SDM 涉及引入选择、描述选项以及探索患者偏好以帮助医疗保健决策，同时赋予妇女权力，减少提供者偏见，提高护理满意度，并增加- 将对护理方案的遵守情况进行测试，以确保提供者和患者能够接受调整后的工具。 Title X 联邦资助的 FP 诊所的客户，这是为因异性恋而感染艾滋病毒风险的女性提供的高覆盖环境在 ADAPT-ITT 适应框架的指导下，具体目标是 (1) 评估的效用。通过 (a) 标题为焦点小组的艾滋病毒预防 SDM 实践以及实施的障碍/促进因素亚特兰大都会区的 X 提供者（K = 4，N = 32）和（b）对种族/民族不同的顺式人进行剧院测试访谈性别成人 Title X 客户 (N=40)；(2) 适应基于证据的世界卫生组织 (WHO) 决定- 为 FP 客户和提供者制作 HIV 预防工具；以及 (3) 进行混合方法可接受性/功能与 Title X 提供商 (N=40) 和客户 (N=40) 一起对改编后的 SDM 工具进行可行性测试本研究将得出以下结果。一个可接受且可行的 HIV 预防 SDM 工具，供参加 FP 诊所的顺性别女性使用进一步测试和传播，以促进妇女预防艾滋病毒，推进终结艾滋病毒的努力此外，这项工作还将支持安德森女士的培训，她致力于成为一名 NIH 资助的高素质研究人员，致力于艾滋病毒预防和治疗以及改善护理互动。安德森女士的3年培训计划包括：（1）正式培养实施方法论技能科学和以人为本的设计，(2) 增进对临床艾滋病毒预防背景的理解，包括生物医学预防和临床相互作用，以及（3）培养测量领域的技能以及干预措施和干预途径的评估。 sor）、Sheth（共同发起人）和 Kottke（专家顾问）将为女士提供监督、指导和指导。安德森在她的培训过程中，在实施科学、艾滋病毒预防、临床等主题领域安德森女士将利用埃默里大学的资源，包括：评估和实施科学网络，评估和实施网络科学、妇女儿童中心和预防研究中心候选人、指导。团队和环境非常适合实现拟议的研究和培训目标。