A Multicomponent Intervention to Train and Support Family Medicine Providers to Promote Pre-exposure Prophylaxis (PrEP) for Adolescent Girls and Young Women in the Deep South: Protocol for the PrEP-Pro Study.
A Multicomponent Intervention to Train and Support Family Medicine Providers to Promote Pre-exposure Prophylaxis (PrEP) for Adolescent Girls and Young Women in the Deep South: Protocol for the PrEP-Pro Study.
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DOI：
10.2196/44908
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发表时间：
2023-03-21
影响因子：
1.7
通讯作者：
Matthews, Lynn
中科院分区：
文献类型：
--
作者：
Isehunwa, Oluwaseyi;Hill, Samantha, V;Menninger, Alex Tobias;Hubner, Brook;Krakower, Douglas;Long, Dustin M.;Pratt, Madeline C.;Clement, Meredith E.;Van Wagoner, Nicholas;Lanzi, Robin Gaines;Simpson, Tina;Elopre, Latesha;Matthews, Lynn
关键词：
暴露前预防（PrEP）是一种非常有效的生物医学预防干预措施，也是减少美国艾滋病毒负担的主要策略。然而，PrEP的提供和吸收仍然低于估计的需求，并且可能加剧美国南部黑人少女和年轻女性之间的艾滋病毒差异。数据表明，提供者在艾滋病毒流行病学和PrEP知识以及评估性健康做法的技能方面的差距是提供和吸收的重要障碍，而解决这些差距的循证干预措施有限。本文介绍了“PrEP-Pro”干预，一个多成分的干预，培训和支持家庭医学（FM）学员，以促进PrEP的青春期女孩和年轻女性在亚拉巴马。PrEP-Pro干预包括3个主要组成部分，由行为改变的能力-机会-动机-行为（COM-B）模型和实施研究综合框架（CFIR）指导：（1）提供者艾滋病毒流行病学和PrEP教育，（2）性史采集，和（3）PrEP冠军。在第一阶段，我们将与社区咨询委员会（提供者和客户）合作，然后与FM学员进行焦点小组讨论，以调整内容，对FM居民进行艾滋病毒流行病学和PrEP培训，并制定实施战略，包括面向提供者的工具和面向客户的教育材料。在第二阶段，我们将对FM学员进行预测试，然后对最初适应的PrEP-Pro干预进行试点测试。FM学员将在PrEP-Pro干预后完成基线、3个月和6个月的问卷调查。我们还将对FM试点参与者，在PrEP-Pro试点后获得护理的少女和年轻女性以及主要利益相关者进行深入访谈。主要结果是PrEP-Pro的可接受性和可行性，将在第3个月（预测试参与者）和第6个月（试点参与者）使用经验证的工具进行评估。还将评估次要结果，包括PrEP知识，性史态度和做法，少女和年轻女性遭遇的PrEP处方，以及6个月内少女和年轻女性遭遇的性传播感染（STI）和艾滋病毒检测。研究结果将分发给实践，州卫生官员和其他主要利益相关者，以征求对实施机会和挑战的反馈，为混合有效性实施试验提供信息。我们的研究结果也将在地方和国家会议上发表，并提交给同行评审的期刊。随着PrEP的发展，迫切需要培训FM提供者，并开发适当的、与上下文相关的工具来支持PrEP的实施。PrEP-Pro干预是一种多成分干预，旨在培训亚拉巴马州的FM居民了解性史，为青春期女孩和年轻女性提供PrEP，并支持基于实践的PrEP冠军。PrEP-Pro干预预计将增加针对少女和年轻女性的PrEP处方，并扩大亚拉巴马农村和城市少女和年轻女性的全面性和生殖健康护理。PRR1-10.2196/44908
Pre-exposure prophylaxis (PrEP) is a highly effective biomedical prevention intervention and a major strategy for reducing the HIV burden in the United States. However, PrEP provision and uptake remain lower than estimated needs, and in ways that may exacerbate HIV disparities among Black adolescent girls and young women in the southern United States. Data suggest that gaps in provider knowledge of HIV epidemiology and PrEP and skills assessing sexual health practices are important barriers to provision and uptake, with limited evidence-based interventions to address these gaps. This paper describes the “PrEP-Pro” intervention, a multicomponent intervention to train and support family medicine (FM) trainees to promote PrEP for adolescent girls and young women in Alabama. The PrEP-Pro intervention comprises 3 main components guided by the Capability-Opportunity-Motivation-Behavior (COM-B) model for behavioral change and the Consolidated Framework for Implementation Research (CFIR): (1) provider HIV epidemiology and PrEP education, (2) sexual history taking, and (3) PrEP Champions. In phase 1, we will work with community advisory boards (providers and clients) and then conduct focus groups with FM trainees to adapt content to train FM residents on HIV epidemiology and PrEP and develop implementation strategies, including provider-facing tools and client-facing educational materials. In phase 2, we will pretest and then pilot-test the initially adapted PrEP-Pro intervention with FM trainees. FM trainees will complete baseline, 3-, and 6-month questionnaires post PrEP-Pro intervention. We will also conduct in-depth interviews (IDIs) with FM pilot participants, adolescent girls and young women who accessed care after the PrEP-Pro pilot, and key stakeholders. The primary outcomes are PrEP-Pro acceptability and feasibility, which would be assessed using validated instruments at months 3 (among pretest participants) and 6 (among pilot participants). Secondary outcomes will also be assessed, including PrEP knowledge, sexual history-taking attitudes and practices, PrEP prescriptions among adolescent girls and young women encounters, and sexually transmitted infections (STIs) and HIV testing among adolescent girls and young women encounters in 6 months. Study results will be disseminated to practices, state health officials, and other key stakeholders to solicit feedback on implementation opportunities and challenges to inform a hybrid effectiveness implementation trial. Our results will also be presented at local and national conferences and submitted to peer-reviewed journals. As PrEP grows, there is a pressing need to train FM providers and develop appropriate, contextually relevant tools to support PrEP implementation. The PrEP-Pro intervention is a multicomponent intervention to train FM residents across Alabama on sexual history-taking, PrEP provision for adolescent girls and young women, and supporting practice-based PrEP Champions. The PrEP-Pro intervention is anticipated to increase PrEP prescriptions for adolescent girls and young women and expand comprehensive sexual and reproductive health care for adolescent girls and young women in rural and urban Alabama. PRR1-10.2196/44908
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影响因子：
9.7
作者：
Arora, Sanjeev;Kalishman, Summers;Yutzy, Sean
通讯作者：
Yutzy, Sean
影响因子：
7.2
作者：
Damschroder, Laura J.;Reardon, Caitlin M.;Widerquist, Marilla A. Opra;Lowery, Julie
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DOI：
10.1023/b:mhsr.0000024351.12294.65
发表时间：
2004-06-01
期刊：
Mental health services research
影响因子：
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通讯作者：
Aarons, Gregory A
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影响因子：
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