Community Engagement to Enhance EBI Implementation in a Public Housing Community

社区参与以加强公共住房社区的 EBI 实施

• 批准号: 8921665
• 负责人: CAROL E GOLIN
• 金额: $ 22.88万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-01 至 2018-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8921665
• 关键词: AIDS prevention; AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Affect; African American; Collaborations; Communities; Consult; Data; Data Collection; Decision Making; Development; Effectiveness; Environment; Epidemic; Evidence based intervention; Focus Groups; Food; Goals; Group Interviews; HIV; Health Services Accessibility; Housing; Incidence; Individual; Intervention; Life; Location; Methods; Modeling; Needs Assessment; North Carolina; Pilot Projects; Population; Poverty; Prevention program; Preventive; Preventive Intervention; Process; Public Health; Public Housing; Qualitative Methods; Reporting; Research Design; Research Methodology; Resources; Risk; Rural; Services; Site; Testing; Time; Transportation; Woman; Work; authority; base; community based participatory research; design; evidence base; high risk; implementation science; improved; innovation; interdisciplinary collaboration; member; prevent; programs; public health relevance; tool; transmission process; trend; urban area

 DESCRIPTION (provided by applicant): For HIV prevention efforts to be most effective they must reach populations most at risk, use efficacious interventions, and be deliverable in real-world settings. While many efficacious evidence-based interventions (EBIs) for HIV prevention currently exist, community-based organizations (CBOs) often have difficulties implementing them among those most likely to benefit, with fidelity, good effect, and sustainability. Structural factors related to poverty often hinder HIV prevention delivery in communities most in need of the programs. For CBOs to successfully prevent the transmission of HIV in high risk communities, strategies to overcome the challenges of implementation are needed. Community-based participatory research (CBPR) offers one approach to work with community members to pinpoint community resources, priorities, needs, and barriers to consider in implementation. This application explores these issues among an often under-recognized group at enormously increased risk of HIV: African American women in the US South. The South is disproportionately affected by the HIV epidemic, with incidence rising over the last decade, and the largest burden on African Americans and women. HIV burden in women has also grown the past 25 years from 8% to over 25% of US AIDS cases. While African American women are only 12% of US women, they comprise 64% of newly infected women. Compounding the great need represented by these disparities, in previous studies, African American women in North Carolina reported significant structural obstacles to accessing HIV prevention programs in their communities, such as lack of transportation and childcare, food insecurity, and competing demands and suggested that program delivery in or near public housing facilities may represent a feasible way to overcome some of these barriers in locations where many people at elevated risk of HIV are concentrated. In a unique, transdisciplinary collaboration between UNC, CAARE, and the Durham Housing Authority, the central objective of this application is to design a structurally-informed implementation program plan for sustainable HIV prevention in public housing developments, using the Real AIDS Prevention Program EBI for African American women, as a test-case model in three aims. We will 1) Engage a broad range of community stakeholders to participate in the design of study methods and adaptation of RAPP for women living in public housing developments in the southern US through CBPR methods; 2) Understand perceived community resources, needs, priorities, and obstacles to the implementation of HIV prevention programs, particularly RAPP, among DHA residents and DHA and CAARE staff; 3) Create a replicable program plan for implementing RAPP within southern housing authority developments and pilot-test the implementation plan within the DHA for fidelity, feasibility, and acceptability.If successful, our next step will be to test the implementation program plan more widely at multiple southern US sites in an R01 application.

 描述(由申请人提供)：为使艾滋病毒预防工作最有效，它们必须接触到最危险的人群，使用有效的干预措施，并在现实世界环境中可交付使用。虽然目前存在许多预防艾滋病毒的有效的循证干预措施(EBI)，但社区组织(CBO)往往难以在最有可能受益的人中实施这些干预措施，而且保真度高、效果好和可持续。结构性 与贫困有关的因素往往阻碍在最需要这些项目的社区开展艾滋病毒预防工作。为使社区组织能够成功地预防艾滋病毒在高危社区的传播，需要制定战略来克服执行方面的挑战。基于社区的参与性研究(CBPR)提供了一种与社区成员合作的方法，以确定社区资源、优先事项、需求和在实施过程中要考虑的障碍。这个应用程序在一个经常被忽视、艾滋病毒风险极大增加的群体中探索这些问题：美国南部的非裔美国妇女。南方受艾滋病毒流行的影响不成比例，发病率在过去十年中有所上升，非洲裔美国人和妇女的负担最大。在过去的25年里，女性的艾滋病毒负担也从占美国艾滋病病例的8%上升到超过25%。虽然非裔美国女性只占美国女性的12%，但她们占新感染女性的%。在以前的研究中，北卡罗来纳州的非裔美国妇女报告了在其社区获得艾滋病毒预防计划的重大结构性障碍，如缺乏交通和儿童保育、食品不安全以及相互竞争的需求，并建议在公共住房设施内或附近提供计划可能是在许多艾滋病毒风险较高的人集中的地区克服其中一些障碍的可行方法。在北卡罗来纳大学、CAARE和达勒姆住房管理局之间的一项独特的跨学科合作中，这项申请的中心目标是设计一个结构知情的实施方案计划，在公共住房开发中可持续地预防艾滋病毒，使用非洲裔美国妇女的真实艾滋病预防计划EBI作为三个目标的测试案例模型。我们将1)动员广泛的社区利益相关者通过CBPR方法参与为居住在美国南部公共住房开发项目中的妇女设计RAPP的研究方法和适应；2)了解DHA居民以及DHA和CAARE工作人员对实施艾滋病毒预防计划，特别是RAP的社区资源、需求、优先事项和障碍的感知；3)为在南部住房管理局开发项目中实施RAP创建可复制的计划计划，并在DHA内对实施计划的保真度、可行性和可接受性进行试点测试。如果成功，我们下一步将在R01应用程序中在美国南部的多个地点更广泛地测试实施计划计划。