Adaptation and Implementation of Project Encuentro in the U.S.-Mexico Border

Encuentro 项目在美墨边境的调整和实施

• 批准号: 9129437
• 负责人: Julia Lechuga
• 金额: $ 44.08万
• 依托单位: UNIVERSITY OF TEXAS EL PASO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-05 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9129437
• 关键词: AIDS prevention; Address; Affect; Area; Awareness; Behavior Therapy; Border Crossings; Cities; Code; Collaborations; Communities; Country; Cross-Sectional Studies; Drug usage; Drug user; Effectiveness; Effectiveness of Interventions; El Salvador; Epidemic; Equipment; Ethnography; Evaluation; Event; Explosion; Face; Feedback; Fright; Goals; HIV; HIV Infections; HIV risk; Heroin; Human immunodeficiency virus test; Immigration; Injection of therapeutic agent; International; Intervention; Interview; Latino; Life; Liquid substance; Mexico; Mission; National Institute of Drug Abuse; Needle-Exchange Programs; Participant; Pharmaceutical Preparations; Phase; Police; Prevention; Preventive Intervention; Process; Research; Research Personnel; Resources; Risk; Risk Behaviors; Risk Reduction; Series; Side; Site; Social Environment; Social Network; Social support; Surveys; Syringes; System; Testing; Texas; Time; United States National Institutes of Health; Universities; Violence; Work; Workplace; base; combat; community based participatory research; community organizations; design; experience; health disparity; implementation science; informant; injection drug use; meetings; member; metropolitan; peer networks; programs; public health relevance; response; sex; social; social stigma; substance abuse treatment; violent crime

 DESCRIPTION (provided by applicant): The proposed project is a research collaboration between the University of Texas at El Paso, The Alliance for Border Collaborative and Program Comparers to adapt, implement, and evaluate a multi-level, community-based, HIV prevention intervention (Project Encuentro). The intervention will target active heroin and crack users and consists of increasing access to HIV testing via a social network HIV testing component and reducing sexual and drug use risk via a peer network brief behavioral Intervention. Encuentro also consists of conducting community awareness meeting to target structural factors affecting HIV risk. The intervention was developed in an area severely affected by violence and stigma towards drug users, El Salvador, which makes it particularly suitable for adaptation to meet the needs of drug users living in the proposed intervention site, the U.S.-Mexico border. The proposed intervention site also has been severely affected by violence which has curtailed any prior attempts to reduce the risk drug users' HIV risk. Violence has worsened structural factors which affect HIV risk such as, increasing police persecution and stigma and reducing access to resources. In our proposed project, we will engage in formative research to understand the context of HIV risk of drug users in the border region post violence and adapt the intervention accordingly. Findings will allow us to tailor intervention components to meet the needs of drug users in the region. Subsequently, we propose to test intervention effectiveness and evaluate implementation barriers and facilitators. To accomplish our project aims we will use a mixed qualitative, quantitative approach. We will begin with a formative phase by conducting in-depth interviews with drug users (n = 40) living in the region to understand how the context of drug use risk changed as a result of the violence and will administer a social network survey (n = 200) to characterize the configuration of risk networks. Findings will yield the necessary information to culturally adapt the intervention to meet the needs of drug users in the region and will help us focus our recruitment efforts where the riskiest networks are located. After the intervention is adapted with the help of our community advisory board and our community coalition, we will implement the intervention and will assess the effectiveness and reach via 6 cross-sectional surveys administered to drug users (n=1,200). We will assess the process of implementation by conducting ethnographic field notes of all intervention activities including community engagement and CAB and coalition meetings. We will assess the fidelity and quality of the intervention. Lastly, we will conduct key informant interviews with key stakeholders involved in the project and interviews and observations will be coded to reflect key systems factors related to successful implementation of intervention components in two intervention sites (El Paso, Texas and Ciudad Juarez, Mexico). Findings will be highly significant as we will be conducting parallel research on the effectiveness of interventions shown to be effective in Latino drug users in two very different contexts: El Salvador and the U.S-Mexico border. Findings will elucidate implementation challenges and barriers and such information can then be used to assess the effectiveness of diverse implementation strategies in organizations working to serve the needs of Latino drug users.

 描述（由申请人提供）：拟议的项目是得克萨斯大学埃尔帕索分校，边境合作联盟和计划比较者之间的研究合作，以适应，实施和评估多层次，以社区为基础的艾滋病预防干预（项目Encuentro）。该干预措施将针对活跃的海洛因和快克使用者，包括通过社交网络艾滋病毒检测部分增加获得艾滋病毒检测的机会，并通过同伴网络简短的行为干预减少性和药物使用风险。Encuentro还包括举办社区宣传会议，以针对影响艾滋病毒风险的结构性因素。干预措施是在一个严重受暴力和对吸毒者的耻辱影响的地区制定的，萨尔瓦多，这使得它特别适合适应，以满足生活在拟议干预地点的吸毒者的需求，美国-墨西哥边境。拟议的干预地点也受到暴力的严重影响，这削弱了先前为降低吸毒者艾滋病毒风险所做的任何努力。暴力加剧了影响艾滋病毒风险的结构性因素，如警察迫害和污名化增加，获得资源的机会减少。在我们拟议的项目中，我们将进行形成性研究，以了解暴力后边境地区吸毒者艾滋病毒风险的背景，并相应地调整干预措施。调查结果将使我们能够调整干预措施，以满足该地区吸毒者的需求。随后，我们建议测试干预的有效性和评估实施的障碍和促进者。为了实现我们的项目目标，我们将使用混合定性，定量的方法。我们将开始形成阶段，对生活在该区域的吸毒者（n = 40）进行深入访谈，以了解吸毒风险的背景如何因暴力而发生变化，并将进行社会网络调查（n = 200），以描述风险网络的结构。调查结果将产生必要的信息，使干预措施在文化上适应该地区吸毒者的需要，并将帮助我们将招募工作的重点放在风险最大的网络所在地。在我们的社区咨询委员会和社区联盟的帮助下调整干预措施后，我们将实施干预措施，并通过对吸毒者进行的6次横断面调查（n= 1 200）评估干预措施的有效性和影响范围。我们将通过对所有干预活动（包括社区参与和CAB及联盟会议）进行人种学实地记录，评估实施过程。我们将评估干预的保真度和质量。最后，我们将与参与项目的主要利益相关者进行关键线人访谈，并对访谈和观察结果进行编码，以反映与两个干预地点（德克萨斯州埃尔帕索和墨西哥华雷斯城）成功实施干预组件相关的关键系统因素。研究结果将非常重要，因为我们将对在两种截然不同的情况下（萨尔瓦多和美墨边境）对拉丁裔吸毒者有效的干预措施的有效性进行平行研究。调查结果将阐明实施的挑战和障碍，这些信息可以用来评估不同的实施战略的有效性，在组织工作，以满足拉丁美洲吸毒者的需求。