Scale it up: Effectiveness-implementation research to enhance HIV-related self-management among youth

扩大规模：加强青少年艾滋病毒相关自我管理的有效性实施研究

• 批准号: 9751093
• 负责人: SYLVIE NAAR
• 金额: $ 440.9万
• 依托单位: FLORIDA STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-30 至 2021-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9751093
• 关键词: AIDS prevention; AIDS/HIV problem; Accounting; Address; Adherence; Adolescence; Adolescent and Young Adult; Adult; Age; Anti-Retroviral Agents; Behavior Therapy; Caring; Competence; Coupled; Decision Making; Detection; Diagnosis; Effectiveness; Epidemic; Foundations; Funding; Goals; HIV; HIV Infections; HIV Seronegativity; Health behavior; Human immunodeficiency virus test; Hybrids; Individual; Infection; Intervention; Intervention Studies; Link; Longevity; Mediating; Mediation; Methods; Modeling; Morbidity - disease rate; Newly Diagnosed; Outcome; Population; Preparation; Prevention; Prevention strategy; Process; Protocols documentation; Research; Research Project Grants; Risk; Safe Sex; Science; Self Management; Site; Testing; Time; Viral; Youth; age group; antiretroviral therapy; base; behavior change; cost effectiveness; demographics; design; emerging adulthood; high risk population; implementation research; implementation science; implementation strategy; improved; intervention effect; mathematical model; pre-exposure prophylaxis; programs; tool; transmission process; young men who have sex with men

Abstract Despite the substantial declines in HIV transmission and increases in lifespan among those living with HIV achieved over the past decade, full benefits that should be possible based on the tools and interventions currently available have yet to be realized in youth, in large part because efficacious interventions for this age group have not been brought to scale. To be effective, youth must be fully engaged in interventions at every stage of the HIV care (treatment and prevention) cascades: HIV testing, linkage to care, timely initiation of care, persistence and adherence to antiretroviral care. At-risk HIV-negative youth need to be consistently engaged in prevention strategies such as PEP and/or PrEP as indicated, consistent safer sex practices and repeat HIV testing. Our U19 project - Scale It Up - specifically focuses on the process of improving self- management among youth including: 1) the identification of interventions that are efficacious and effective for improving self-management in YLH and at risk youth; 2) the multi-site implementation of an intervention shown to be efficacious in improving self-management; and 3) the assessment of the Five Components of Self- Management Model and how these vary over time, are directly improved by interventions, and mediate intervention effects. Our team has also been at the leading edge of implementation Science research related to HIV prevention and care. We are actively committed to aggressively moving beyond simple efficacy and effectiveness RCTs. The four Research Projects proposed in Scale It Up, all addressing self-management, will continue to develop the field of Implementation Science by employing three types of effectiveness- implementation hybrid designs. The studies further synergize by utilizing Aaron’s Exploration, Preparation, Implementation, Sustainment (EPIS) model to guide the proposed Implementation Science efforts. Our proposed Implementation Science Core, coupled with the cost effectiveness expertise of our Analytic Core, will be focused on the central notion of “Scale It Up” – taking efficacious self-management interventions and expeditiously moving them into practice while sustaining effectiveness. Scale It Up has assembled research teams who will develop, test, and bring to practice self-management interventions that positively impact the youth HIV prevention and care cascades. We will achieve these goals by: 1) Designing, conducting and evaluating self-management interventions grounded in the 5-component Self-Management Model and expeditiously moving effective programs into practice; 2) Developing, deploying and disseminating new methods for implementation and implementation analysis with a strong theoretical foundation; and 3) Engaging with the other funded U19s to identify additional opportunities to advance the implementation science and self- management science.

摘要 尽管艾滋病毒传播大幅下降， 在过去十年中取得的艾滋病毒防治成果，在工具和干预措施的基础上， 在青年中尚未实现，这在很大程度上是因为针对这个年龄段的有效干预措施 组还没有被放大。为了取得成效，青年必须充分参与每一次干预行动， 艾滋病毒护理（治疗和预防）级联阶段：艾滋病毒检测、与护理挂钩、及时启动 护理、坚持和坚持抗逆转录病毒治疗。艾滋病毒阴性的高危青年需要始终如一地 参与预防策略，如PEP和/或PrEP，持续的安全性行为， 重复HIV检测。我们的U19项目-扩展它-特别侧重于提高自我的过程， 青年管理，包括：1）确定有效和有效的干预措施， 改善YLH和高危青少年的自我管理; 2）多地点实施干预措施， 有效地改善自我管理; 3）自我管理的五个组成部分的评估 管理模式以及这些模式如何随着时间的推移而变化，通过干预措施直接改善， 干预效果。我们的团队也一直处于实施科学研究的前沿， 艾滋病毒预防和护理。我们积极致力于积极超越简单的功效， 有效性RCT。在《扩大规模》中提出的四个研究项目都涉及自我管理，将 通过采用三种类型的有效性，继续发展实施科学领域- 实现混合设计。这些研究进一步协同利用亚伦的探索，准备， 实施，可持续（EPIS）模型，以指导拟议的实施科学工作。我们 拟议的实施科学核心，加上我们的分析核心的成本效益专业知识，将 专注于“扩大规模”的中心概念-采取有效的自我管理干预措施， 迅速将其付诸实践，同时保持有效性。Scale It Up已经收集了研究 团队谁将开发，测试，并把实践自我管理干预，积极影响 青年艾滋病毒预防和护理级联。我们将通过以下方式实现这些目标：1）设计、执行和 评估基于五要素自我管理模型的自我管理干预措施， 快速将有效的方案付诸实践; 2）开发、部署和传播新的 具有坚实理论基础的实施方法和实施分析;以及3）参与 与其他受资助的U19一起，确定更多的机会，以促进实施科学和自我- 管理科学