Adolescent Trials Network for HIV-AIDS Scale It Up Program: Protocol for a Rational and Overview
Adolescent Trials Network for HIV-AIDS Scale It Up Program: Protocol for a Rational and Overview
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DOI：
10.2196/11204
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发表时间：
2019-02-01
影响因子：
1.7
通讯作者：
Stanton, Bonita F.
中科院分区：
文献类型：
--
作者：
Naar, Sylvie;Parsons, Jeffrey T.;Stanton, Bonita F.
背景资料：过去30年来，在预防和治疗艾滋病毒/艾滋病方面取得了如此重大的进展，使一代人没有艾滋病和在全球范围内消除艾滋病流行是雄心勃勃但可以实现的国家和全球目标。尽管越来越乐观，但在全球范围内，感染艾滋病毒的青年接受抗逆转录病毒治疗的可能性明显低于成年人（23%对38%）。此外，在艾滋病毒感染风险方面存在着明显的健康差距，与男性发生性关系的有色人种青年受到的影响不成比例。大量研究已经确定了行为改变的高度影响力的促进者和障碍。已经制定了一些有效的干预措施，以降低青年人中新感染艾滋病毒的比率，并降低感染艾滋病毒的青年人的发病率。然而，基于现有工具和干预措施的全部惠益尚未在青年中实现，这在很大程度上是因为尚未在现实世界中实施有效的干预措施。扩大规模（SIU）的主要目的是组建研究团队，最终将对青年艾滋病毒预防和护理级联产生积极影响的循证干预措施付诸实践，并进而推进实施科学和自我管理科学领域。目标：本文旨在描述U19-SIU的结构和有效性-实施混合试验，以及其他中心范围的协议和倡议，在SIU内实施。方法：SIU将通过4个单独的主要协议，2个中心范围的协议和3个跨项目倡议来实现其目标。结果：SIU由国家儿童健康和人类发展研究所（U19 HD 089875）资助，于2016年10月开始。截至2018年11月，已有6个SIU协议至少启动了第一阶段工作（ATN 144 SMART：序贯多任务随机试验; ATN 145 YMHP：青年男性健康项目; ATN 146 TMI：定制动机访谈干预; ATN 153 EPIS：探索、准备、实施、维持模型; ATN 154 CM：级联监测; ATN 156我们测试：夫妻沟通和艾滋病毒检测）。进一步的细节可以发现在个别协议paper.Conclusions：迄今为止，青年艾滋病毒研究组合还没有充分推进自我管理的重要护理领域。SIU的协议和举措通过重点评估自我管理干预措施的有效性和实施情况来解决这一广泛问题。SIU是高度创新的5个主要原因：（1）我们的研究框架扩展了“自我管理”的应用;（2）4个主要协议利用创新的混合设计;（3）我们的分析核心将进行每一个干预的成本效益分析;（4）在所有4个主要协议中，我们的实施科学核心将应用旨在评估内部和外部环境因素的实施量表;以及（5）我们将通过分析记录的交互来促进对提供者和患者之间的动态的理解。
Background: The past 30 years have witnessed such significant progress in the prevention and treatment of HIV/AIDS that an AIDS-free generation and the end to the global AIDS epidemic are ambitious, but achievable, national and global goals. Despite growing optimism, globally, youth living with HIV are markedly less likely to receive antiretroviral therapy than adults (23% vs 38%). Furthermore, marked health disparities exist regarding HIV infection risk, with young men of color who have sex with men disproportionately affected. A large body of research has identified highly impactful facilitators of and barriers to behavior change. Several efficacious interventions have been created that decrease the rate of new HIV infections among youth and reduce morbidity among youth living with HIV. However, full benefits that should be possible based on the tools and interventions currently available are yet to be realized in youth, in large part, because efficacious interventions have not been implemented in real-world settings. Scale It Up (SIU) primarily aims to assemble research teams that will ultimately bring to practice evidence-based interventions that positively impact the youth HIV prevention and care cascades, and in turn, advance the fields of implementation science and self-management science.Objective: This paper aims to describe the structure of the U19-SIU and the effectiveness-implementation hybrid trials, as well as other center-wide protocols and initiatives, implemented within SIU.Methods: SIU will achieve its aims through 4 individual primary protocols, 2 center-wide protocols, and 3 cross-project initiatives.Results: SIU was funded by National Institute for Child Health and Human Development (U19HD089875) and began in October 2016. As of November 2018, 6 SIU protocols have launched at least the first phase of work (ATN 144 SMART: Sequential Multiple Assignment Randomized Trial; ATN 145 YMHP: Young Men's Health Project; ATN 146 TMI: Tailored Motivational Interviewing Intervention; ATN 153 EPIS: Exploration, Preparation, Implementation, Sustainment model; ATN 154 CM: Cascade Monitoring; ATN 156 We Test: Couples' Communication and HIV Testing). Further details can be found in the individual protocol papers.Conclusions: To date, the youth HIV research portfolio has not adequately advanced the important care area of self-management. SIU protocols and initiatives address this broad issue by focusing on evaluating the effectiveness and implementation of self-management interventions. SIU is highly innovative for 5 primary reasons: (1) our research framework expands the application of " self-management"; (2) the 4 primary protocols utilize innovative hybrid designs; (3) our Analytic Core will conduct cost-effectiveness analyses of each intervention; (4) across all 4 primary protocols, our Implementation Science Core will apply implementation scales designed to assess inner and outer context factors; and (5) we shall advance understanding of the dynamics between provider and patient through analysis of recorded interactions.