Implementation Science to Strengthen the Integrated Care Continuum in Getting to Zero Contexts

项目总结 在这份职业发展建议中，我的目标是使用实施科学战略来评估 归零(GTZ)框架内的综合护理连续体。GTZ框架提出了扩展和 扩大有效的艾滋病毒治疗和预防干预措施，如暴露前预防和 治疗即预防(TasP)，目标是消除新的艾滋病毒传播事件。GTZ倡议包括 最常见的是通过综合护理连续体来运作。综合护理连续体系描述了 艾滋病毒阳性和艾滋病毒阴性但易感人群的艾滋病毒护理和预防措施：这两个方面都至关重要 结束艾滋病毒的传播。许多司法管辖区采取了系统性的努力来结束艾滋病毒的传播。 通过实现零倡议。在执行方面出现了挑战，主要挑战是 监控、评估并为实施中的迭代改进提供及时反馈 策略。为了在有限的资源内提高效率，德国技术合作区的努力需要系统和 定期评估，为成功实施提供反馈-数据驱动的 实施科学。开发和组织监测和评价系统已得到承认 作为一种离散的实施战略。显然有必要制定严格的评估方法 一个实施科学框架，可以为GTZ计划的公共卫生实施者提供明确和 当代反馈，并作为推动综合护理连续体系周期性改进的工具 结果。对于这份职业发展建议，我将使用探索、准备、实施和 可持续发展(EPIS)模型，与公众合作探索在伊利诺伊州采用GTZ评估工具 健康伙伴。因此，该提案将1)使用执行框架来审查能力， 主要利益相关者采用不同数据来源评估GTZ消除艾滋病毒的准备情况和可行性 努力，2)证明候选数据来源在评价 通过案例说明综合护理的连续性；3)开发综合护理评估工具 通过数据监测和反馈实现连续性。来自这项提案的知识将填补 如何通过监测、反馈和评估的形式提供针对具体情况的实施支持 在消除艾滋病毒的多管齐下的司法计划内。由此产生的知识有可能 在伊利诺伊州和其他司法管辖区推动消除工作的服务改进。这个K奖将 提供实施研究、健康服务和混合方法方面的高级培训 我在流行病学和艾滋病毒预防方面的背景。我将把我的研究经验与我的 我强大的指导团队培养了成为一名独立调查员所需的技能。这些 经验将使我成为艾滋病毒预防和实施领域的领导者。

PROJECT SUMMARY In this career development proposal, I aim to use implementation science strategies for evaluation of the integrated care continuum within a Getting to Zero (GTZ) Framework. GTZ frameworks propose expansion and scale-up of effective HIV treatment and prevention interventions such as pre-exposure prophylaxis (PrEP) and treatment as prevention (TasP), with the goal of eliminating new HIV transmission events. GTZ initiatives are most commonly operationalized through integrated care continuums. The integrated care continuum describes HIV care and prevention steps for HIV positive and HIV negative, but susceptible, persons: both critical to ending HIV transmission. Many jurisdictions have undertaken systematic efforts to end HIV transmission through Getting to Zero initiatives. Challenges in implementation have occurred, with a primary one being monitoring, evaluating, and providing timely feedback for iterative improvements in the implementation strategy. In order to be efficient within constrained resources, GTZ efforts need to be systematically and routinely assessed to provide feedback for successful implementation – a data-driven cornerstone of implementation science. Developing and organizing monitoring and evaluation systems has been recognized as a discrete implementation strategy. There is a clear need to develop rigorous methods of evaluation within an implementation science framework that can provide public health implementers of GTZ plans clear and contemporary feedback, and serve as a tool driving cyclical improvements in integrated care continuum outcomes. For this career development proposal, I will use the Exploration, Preparation, Implementation, and Sustainment (EPIS) model to explore adoption of a GTZ evaluation tool in Illinois in collaboration with public health partners. Therefore, this proposal will 1) use an implementation framework to examine capacity, readiness and feasibility of key stakeholders to adopt diverse data sources to evaluate GTZ HIV elimination efforts, 2) demonstrate the appropriateness and feasibility of candidate data sources in evaluating the integrated care continuum through a case example, and 3) develop tools for evaluation of the integrated care continuum through data monitoring and feedback. The knowledge from this proposal will fill important gaps in how to provide context-specific implementation support in the form of monitoring, feedback, and evaluation within multi-pronged jurisdictional programs for HIV elimination. The resulting knowledge has the potential to drive service improvements for elimination efforts both in Illinois and other jurisdictions. This K award will provide advanced training in implementation research, health services, and mixed methods that will build on my background in epidemiology and HIV prevention. I will bring my research experience together with that of my strong mentorship team to develop the skills necessary to become an independent investigator. These experiences will position me to become a leader in the field of HIV prevention and implementation.