Developing and Pilot Testing Peer Ambassador Stories for Increasing HIV-Prevention and Behavioral Health Treatment Uptake among Latino MSM

开发和试点测试同伴大使故事，以提高拉丁裔 MSM 的艾滋病毒预防和行为健康治疗接受率

• 批准号: 10453054
• 负责人: Audrey Harkness
• 金额: $ 15.81万
• 依托单位: UNIVERSITY OF MIAMI SCHOOL OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-25 至 2023-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10453054
• 关键词: AIDS prevention; Age; Collaborations; Communities; Consent; Consultations; County; Data; Development; Ensure; Epidemic; Feedback; Focus Groups; Foundations; Goals; HIV; Health Personnel; Health Services; Human immunodeficiency virus test; Immigration; Incidence; Infrastructure; Institutes; Interview; Knowledge; Latino; Lead; Link; Mental Health; Methods; Names; Outcome; Parents; Participant; Personal Satisfaction; Phase; Pilot Projects; Prevalence; Race; Randomized; Reading; Recording of previous events; Research; Resources; Science; Scientific Advances and Accomplishments; Services; Sexual and Gender Minorities; Stigmatization; Structure; Surveys; Technology; Testing; Translations; Universities; arm; base; behavioral health; community partnership; cost; data format; design; effectiveness implementation trial; evidence base; experience; follow-up; health disparity; health equity; health service use; implementation outcomes; implementation science; implementation strategy; men; men who have sex with men; minority health; outreach; peer; peer influence; pilot trial; pre-exposure prophylaxis; preventive intervention; primary outcome; programs; prototype; recruit; substance use; uptake; web site

Project Summary Background. Miami is an HIV hotspot, driven by HIV disparities among Latino men who have sex with men (LMSM). Behavioral health problems (e.g., mental health, substance use) contribute to HIV acquisition, forming synergistic disparities. Yet, Latino MSM are underreached by proven HIV-prevention interventions (e.g., pre- exposure prophylaxis) and behavioral health treatments. The parent K23 is developing and pilot testing an implementation strategy (Dime Más) to increase the reach of PrEP, HIV testing, and behavioral health treatment to LMSM. Informed by the PI's preliminary data, the proposed supplement seeks to develop and pilot test another implementation strategy, which leverages LMSM peer influence, to enhance the reach of PrEP, HIV testing, and behavioral health treatment to LMSM. To advance health disparities science and achieve the Ending the HIV Epidemic goals, tailored implementation strategies are needed to ensure the equitable delivery of PrEP, HIV testing, and behavioral health services to LMSM. Research Strategy. Aim 1: Identify LMSM priorities for the content and design of the peer ambassador stories. From my preliminary data, I anticipate that the peer ambassador stories will be an app/website/forum that shows LMSM's personal stories of obtaining PrEP and behavioral health treatments. Users will interface by watching the peer stories and potentially chatting with peers within the platform. Results of two phases of formative research (interviews and theater tests with LMSM) will be used to refine the peer ambassador stories and develop the final module to be used in the pilot test. Aim 2: Pilot test the peer ambassador stories. Building on the parent K23, which is conducting a pilot test comparing Dime Más to standard outreach (control), I will utilize the proposed supplement to add a third arm to the pilot trial: the peer ambassador stories. LMSM will be randomized 1:1:1 to each condition (N=90, ~50% U.S. born). The supplement will evaluate the impact of the peer stories vs. control (and Dime Más vs. control) on health disparities by examining PrEP, HIV testing, and behavioral health uptake across groups and exploring mechanisms of effects. We will also examine implementation outcomes associated with the peer stories (e.g., appropriateness, acceptability, feasibility, cost) via exit interviews and surveys with participants and outreach workers. Outcomes. The proposed supplement will bolster the parent K23, which is developing and pilot testing Dime Más, an implementation strategy to enhance the reach of PrEP, HIV testing, and behavioral health services to LMSM, by adding a robust peer component. If the peer stories alone are acceptable and lead to increased uptake, the K23 will generate two strategies for increasing reach among LMSM, one which is intensive and one which is less intensive but potentially more scalable to lower resource settings. The findings will lay the foundation for a subsequent R01 effectiveness-implementation trial, further advancing scientific knowledge about these implementation strategies on LMSM disparities. This supplement will identify strategies for achieving HIV and behavioral health equity for LMSM, aligned with the EHE plan.

项目摘要 背景迈阿密是艾滋病热点地区，这是由与男性发生性关系的拉丁裔男性之间的艾滋病差异造成的 （LMSM）。行为健康问题（例如，精神健康，物质使用）有助于艾滋病毒的获得，形成 协同差异。然而，拉丁裔男男性行为者没有得到经证实的艾滋病毒预防干预措施的帮助（例如，表示“前 暴露预防）和行为健康治疗。母公司K23正在开发和试点测试， 实施战略（Dime Más），以扩大PrEP、艾滋病毒检测和行为健康的覆盖面 治疗LMSM。根据PI的初步数据，拟议的补充旨在开发和试点 测试另一种实施策略，该策略利用LMSM同伴的影响力，以提高PrEP的覆盖范围， 艾滋病毒检测和行为健康治疗LMSM。科学推进健康差距，实现 结束艾滋病毒流行病的目标，需要有针对性的执行战略，以确保公平地提供 艾滋病毒检测和行为健康服务。研究战略。目标1：识别LMSM 优先考虑同行大使故事的内容和设计。从我的初步数据来看，我预计 同行大使的故事将是一个应用程序/网站/论坛，显示LMSM的个人故事，获得 PrEP和行为健康治疗。用户将通过观看同行故事进行交互， 与平台内的同行聊天。形成性研究的两个阶段（访谈和戏剧）的结果 测试与LMSM）将用于完善同行大使的故事，并开发最终的模块，用于 试点测试。目标2：试点测试同行大使的故事。在母公司K23的基础上， 试点测试比较一角钱更多的标准外展（控制），我将利用拟议的补充，以增加一个 试点试验的第三个武器：同行大使的故事。LMSM将以1：1：1的比例随机分配至每种条件 （N=90，约50%出生于美国）。该补充将评估同伴故事与对照组（以及Dime）的影响 Más与对照组）通过检查PrEP，HIV检测和行为健康吸收来研究健康差异。 小组并探索影响机制。我们还将审查与以下方面有关的实施成果： 对等体故事（例如，适当性、可接受性、可行性、成本）， 参与者和外展工作者。结果。拟议的补充将加强母公司K23，这是 制定并试行Dime Más，这是一项旨在扩大PrEP、艾滋病毒检测、 和行为健康服务的LMSM，通过添加一个强大的对等组件。如果仅仅是同龄人的故事 可接受的，并导致增加吸收，K23将产生两个战略，以增加 LMSM，一种是密集型的，另一种是密集型的，但可能更具可扩展性，以减少资源 设置.这些发现将为随后的R 01有效性实施试验奠定基础， 推进关于LMSM差异的这些实施战略的科学知识。这种补充剂 将确定战略，实现艾滋病毒和行为健康的LMSM的公平，与EHE计划保持一致。