Midwest TXTXT: Scale up of an Evidence-Based Intervention to Promote HIV Medication Adherence

项目总结摘要 在此应用程序中，我们建议通过创建区域枢纽来扩大基于证据的干预-TXTXT 在中西部地区协调广泛传播，并大幅提高覆盖范围和影响力。我们将评估 通过第二类混合设计扩大EBI的实施范围，以广泛传播 基于区域的实施模式，并将为TXTXT制定可持续发展计划，以告知大范围 传播并迅速扩大到其他美国地区。 具体目标： 1.确定EBI-TXTXT-在我们的主要和 次要结果：依从性、病毒载量抑制和保留在艾滋病毒护理中，在 依从性差的种族/少数民族青年会，年龄16-35岁，3个月和6个月的随访。 2.应用实施研究综合框架(CFIR)来描述实施 处理和确定需要解决的障碍和促进者；并衡量实施情况 使用RE-AIM框架进行TXT干预的结果(REACH、有效性、采用、 实施、维护)。 约翰逊博士是以艾滋病毒为重点的实施科学导师奖的理想候选人。她是个 受过培训的传染病流行病学家，拥有实施科学方法和 方法(尚未应用)。作为一名早期职业生涯中的艾滋病毒预防科学家，她有一丝经验 源于社区参与的研究，其中包括基础科学，包括监测和 流行病学以及干预发展和能力发展举措。下一个合乎逻辑的步骤是 掌握系统级实施科学和可持续发展规划方面的技能，为广泛传播提供信息 以证据为基础的干预措施。这项研究结合了行为科学和社会科学、实施科学、 并朝着影响公共卫生的最终目标传播信息。坚持用药是关键 病毒抑制和这一地区性TXT倡议的驱动力，具有更长期的国家目标 传播并将重点放在病毒学失败风险最高的患者身上，将直接针对当地、地区和 到2030年结束这一流行病的国家目标。

PROJECT SUMMARY ABSTRACT In this application, we propose to scale up an Evidence-Based Intervention- TXTXT- by creating a regional hub in the Midwest to coordinate broad dissemination, and to greatly increase reach and impact. We will evaluate the implementation of the EBI scale up via a hybrid type II design to inform the broad dissemination of a region-based implementation model and will elaborate a sustainability plan for TXTXT to inform wide scale dissemination and rapid scale up to additional US regions. Specific Aims: 1. Determine the real-world efficacy of a regional scale up of an EBI- TXTXT- on our primary and secondary outcomes: adherence, viral load suppression, and retention in HIV care, respectively, among poorly adherent racial/ethnic minority YLH, ages 16-35 at 3-and 6-month follow-up. 2. Apply the Consolidated Framework for Implementation Research (CFIR) to describe the implementation process and identify barriers and facilitators needed to be addressed; and measure implementation outcomes of the TXTXT intervention using the RE-AIM framework (Reach, Efficacy, Adoption, Implementation, Maintenance). Dr. Johnson is an ideal candidate for an HIV-focused Implementation Science mentorship award. She is a trained Infectious Disease Epidemiologist with initial certification in Implementation Science approaches and methods (not yet applied). As an early career HIV prevention scientist, she has a breath of experience that stems from community-engaged research which includes basic science, including surveillance and epidemiology as well as intervention development and capacity development initiatives. The next logical step is to gain skills in systems-level implementation science and sustainability planning to inform broad dissemination of evidence-based interventions. This study combines behavioral and social science, implementation science, and information dissemination towards the ultimate goal of public health impact. Medication adherence is a key driver of viral suppression and this regional TXTXT initiative, with a longer-term objective of national dissemination and focused on patients at most risk of virologic failure will directly address local, regional and national goals to End the Epidemic by 2030.