POWER Up-Improving pre-exposure prophylaxis (PrEP) uptake among Black cisgender women in the Southern United States: Protocol for a stepped-wedge cluster randomized trial (SW-CRT).
POWER Up-Improving pre-exposure prophylaxis (PrEP) uptake among Black cisgender women in the Southern United States: Protocol for a stepped-wedge cluster randomized trial (SW-CRT).
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美国南部黑色顺性妇女的曝光前预防预防（PREP）吸收的功率：阶梯式叶状群集随机试验（SW-CRT）的方案。
DOI：
10.1371/journal.pone.0285858
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发表时间：
2023
期刊：
影响因子：
3.7
通讯作者：
Johnson, Amy K. K.
中科院分区：
文献类型：
--
作者：
Ridgway, Jessica P. P.;Devlin, Samantha A. A.;Friedman, Eleanor E. E.;Enaholo, Ososese E. E.;Pyra, Maria;Hirschhorn, Lisa R. R.;Haider, Sadia;Ducheny, Kelly;Johnson, Amy K. K.
艾滋病毒对美国黑人/非裔美国人顺性别妇女（以下简称妇女）的影响不成比例。尽管其有效性已得到证明，但用于预防艾滋病毒的暴露前预防（PrEP）仍然根据妇女的需要远远不足。增加妇女对PrEP的吸收和坚持对减少艾滋病毒传播至关重要;然而，很少有专门针对妇女的研究。本文介绍了研究协议，用于评估的可行性，可接受性和有效性的实施策略，以提高在中西部和南部的黑人妇女的PrEP吸收和持久性。PrEP优化妇女以提高保留和摄取（POWER UP）是一个以证据为基础的，以妇女为中心的五项实施科学战略，解决了在提供者，患者和诊所层面使用PrEP的障碍。POWER Up包括1）患者的常规PrEP教育，2）标准化的提供者培训，3）电子病历（EMR）优化，4）PrEP导航和5）PrEP临床冠军。这些策略将适用于具体的诊所实施，通过阶梯楔形试验进行测试，如果有效，将打包进一步传播。我们将利用一项阶梯楔形分组随机试验（SW-CRT）来衡量不同地理区域PrEP利用率的变化。需要为调整和实施这一系列战略做好准备，以确定如何使其适应特定的诊所。实施方面的挑战将包括利用每个研究中心的可用资源调整策略，保持利益相关者的参与和工作人员的认同，根据需要调整研究方案和计划程序，并确保最小的交叉。此外，必须在适应和执行进程之前、期间和之后审查每项战略的长处和局限性。最后，必须对战略的执行结果进行评估，以确定战略在现实世界中的成功。这项研究是解决PrEP服务提供不平等和增加美国黑人妇女PrEP利用率的重要一步。
HIV disproportionately affects Black/African American cisgender women (hereafter women) in the United States. Despite its proven effectiveness, pre-exposure prophylaxis (PrEP) for HIV prevention remains vastly under-prescribed to women based on their need. Increasing PrEP uptake and persistence among women is crucial to reducing HIV transmission; however, there have been few studies designed specifically for women. This article describes the study protocol used to assess the feasibility, acceptability, and effectiveness of implementation strategies to improve PrEP uptake and persistence among Black women in the Midwest and South. PrEP Optimization among Women to Enhance Retention and Uptake (POWER Up) is an evidence-based, woman-focused set of five implementation science strategies that addresses barriers of PrEP utilization at the provider, patient, and clinic levels. POWER Up includes 1) routine PrEP education for patients, 2) standardized provider training, 3) electronic medical record (EMR) optimization, 4) PrEP navigation, and 5) PrEP clinical champions. These strategies will be adapted to specific clinics for implementation, tested via a stepped-wedge trial, and, if effective, packaged for further dissemination. We will utilize a stepped-wedge cluster randomized trial (SW-CRT) to measure change in PrEP utilization across diverse geographic areas. Preparation for adapting and implementing the bundle of strategies is needed to determine how to tailor them to specific clinics. Implementation challenges will include adapting strategies with the available resources at each site, maintaining stakeholder involvement and staff buy-in, adjusting the study protocol and planned procedures as needed, and ensuring minimal crossover. Additionally, strengths and limitations of each strategy must be examined before, during, and after the adaptation and implementation processes. Finally, the implementation outcomes of the strategies must be evaluated to determine the real-world success of the strategies. This study is an important step toward addressing the inequity in PrEP service delivery and increasing PrEP utilization among Black women in the U.S.
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影响因子：
7.2
作者：
Damschroder, Laura J.;Reardon, Caitlin M.;Widerquist, Marilla A. Opra;Lowery, Julie
通讯作者：
Lowery, Julie
DOI：
10.1097/qai.0000000000002548
发表时间：
2021-02-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Teixeira da Silva D;Bouris A;Ramachandran A;Blocker O;Davis B;Harris J;Pyra M;Rusie LK;Brewer R;Pagkas-Bather J;Hotton A;Ridgway JP;McNulty M;Bhatia R;Schneider JA
通讯作者：
Schneider JA
影响因子：
2
作者：
Hooper, Richard;Teerenstra, Steven;Eldridge, Sandra
通讯作者：
Eldridge, Sandra
DOI：
10.1097/qai.0000000000002042
发表时间：
2019-08-01
影响因子：
3.6
作者：
Calabrese, Sarah K.;Willie, Tiara C.;Kershaw, Trace S.
通讯作者：
Kershaw, Trace S.
DOI：
10.1097/qai.0000000000002377
发表时间：
2020-08-15
影响因子：
3.6
作者：
Hirschhorn, Lisa R.;Brown, Rayna N.;Ridgway, Jessica P.
通讯作者：
Ridgway, Jessica P.