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: 9281080
• 负责人: CAROL E GOLIN
• 金额: $ 22.27万
• 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 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9281080
• 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; Evidence based program; Focus Groups; Food; Goals; Group Interviews; HIV; Health Services Accessibility; Housing; Incidence; Individual; Intervention; Location; Methods; Modeling; Needs Assessment; North Carolina; Population; Poverty; Prevention program; Preventive Intervention; Preventive service; Process; Public Health; Public Housing; Qualitative Methods; Reporting; Reproducibility; Research Methodology; Resources; Risk; Rural; Site; Testing; Time; Time Study; 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; therapy design; 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）：为了使艾滋病毒预防工作最有效，它们必须覆盖到最危险的人群，使用有效的干预措施，并可在现实环境中实施。虽然目前存在许多有效的艾滋病毒预防循证干预措施 (EBI)，但社区组织 (CBO) 在最有可能受益的人群中实施这些干预措施时常常遇到困难，难以保真度、良好效果和可持续性。结构性 与贫困有关的因素常常阻碍在最需要项目的社区提供艾滋病毒预防工作。为了使社区组织成功预防艾滋病毒在高风险社区的传播，需要制定克服实施挑战的策略。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、需求和实施过程中需要考虑的障碍。该应用程序探讨了一个经常被忽视的艾滋病毒风险极大增加的群体：美国南部的非裔美国妇女中的这些问题。南方受艾滋病毒流行的影响尤为严重，过去十年发病率不断上升，非洲裔美国人和妇女的负担最大。过去 25 年来，女性感染艾滋病毒的负担也从占美国艾滋病病例的 8% 增加到了 25% 以上。尽管非洲裔美国女性仅占美国女性的 12%，但她们却占新感染女性的 64%。使这些差异所代表的巨大需求更加复杂化的是，在之前的研究中，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，例如缺乏交通和儿童保育、粮食不安全和相互竞争的需求，并建议在公共住房设施内或附近提供计划可能是克服许多艾滋病毒高危人群集中地区的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独特的跨学科合作中，该应用程序的核心目标是设计一个结构合理的实施方案计划，以在公共住房开发中实现可持续的艾滋病毒预防，使用针对非裔美国妇女的真正艾滋病预防计划 EBI 作为三个目标的测试案例模型。我们将 1) 通过 CBPR 方法，让广泛的社区利益相关者参与针对美国南部公共住房开发项目中居住的女性的 RAPP 研究方法的设计和调整； 2) 了解 DHA 居民以及 DHA 和 CAARE 工作人员感知到的社区资源、需求、优先事项以及实施 HIV 预防计划（特别是 RAPP）的障碍； 3) 创建一个可复制的计划计划，在南部住房管理局开发项目中实施 RAPP，并在 DHA 内试点测试实施计划的保真度、可行性和可接受性。如果成功，我们下一步将在 R01 申请中在美国南部多个地点更广泛地测试实施计划计划。