Scaling Up Implementation Strategies to Improve the DIAGNOSE and PREVENT Pillars for Young MSM in Florida

摘要 该项目将在佛罗里达州范围内发起一项努力，以促进对发展敏感、文化上敏感的 适当和循证的诊断和预防咨询、检测和转诊服务(CTR) 与男性发生性关系的年轻男性(基督教青年会)。目标是利用实施科学战略来 提高艾滋病毒保健部队提供循证做法的能力(减少风险咨询、 准备推荐和量身定做的激励性面试)。我们最新的基督教青年会之谜 在三个城市的CTR网站进行的购物者研究表明，供应商严重缺乏准备或正在 不知道如何向基督教青年会和密西西比州提供适合发展的、具有文化竞争力的CTR服务 提供这些循证实践的机会。神秘购物者是一种质量管理战略，以 监测CTR环境中对文化和发展响应的EBP的实施保真度。然而， 仅有评估和反馈不足以提高保真度；必须对HealthForce进行适当的培训 并给予技术援助。我们建议整合两个实施策略：质量管理 神秘购物者和HealthForce通过集中技术进行量身定做的激励性面试培训 援助。我们将在佛罗里达的七个EHE测试以青少年为中心的医疗力量培训(游艇)套餐 在卫生署的42个签约地点中，至少有24名年轻男男性接触者接受了CTR 在过去的12个月里，使用了阶梯式楔形设计。我们为这两个成效成果提供动力(#年#月#日 YMSM测试)和实施结果(基于Mystery Shopper评估的EBP保真度) 与类型2混合试验一致。

Abstract This project will launch a Florida wide effort to promote the delivery of developmentally sensitive, culturally appropriate and evidence-based DIAGNOSE and PREVENT counseling testing and referral services (CTR) for young men who have sex with men (YMSM). The goal is to leverage implementation science strategies to improve the capacity of the HIV HealthForce to deliver evidence-based practices (risk reduction counseling, PrEP referral and Tailored Motivational Interviewing) within CTR services. Our recent YMSM Mystery Shoppers studies conducted at CTR sites in three cities indicated that providers are woefully unprepared or do not know how to deliver developmentally appropriate, culturally competent CTR services to YMSM and miss opportunities to deliver these evidence-based practices. Mystery Shopper is a quality management strategy to monitor implementation fidelity to culturally and developmentally responsive EBPs in CTR settings. However, assessment and feedback alone are insufficient to improve fidelity; the HealthForce must be properly trained and given technical assistance. We propose integrating two implementation strategies: quality management Mystery Shoppers and HealthForce training in Tailored Motivational Interviewing with centralized technical assistance. We will test Young Adult Centered HealthForce Training (YACHT) package in Florida’s seven EHE counties among the Department of Health’s 42 contracted sites who delivered CTR to at least 24 young MSM in the previous 12 months using a Stepped Wedge design. We power on both effectiveness outcomes (# of tests of YMSM) and implementation outcomes (EBP fidelity based on Mystery Shopper Assessments) consistent with a Type 2 Hybrid trial.