Implementation of a triadic network case management intervention for younger Black sexual minority men

对年轻黑人性少数男性实施三元网络案例管理干预

• 批准号: 10548326
• 负责人: Alida M Bouris
• 金额: $ 73.8万
• 依托单位: UNIVERSITY OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-09 至 2027-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10548326
• 关键词: Accountability; Address; Adoption; Attention; Black race; COVID-19; Caring; Case Management; Case Manager; Client; Climate; Communities; Computerized Medical Record; Consolidated Framework for Implementation Research; Consultations; Consumption; Contact Tracing; Continuity of Patient Care; Counseling; Data; Data Collection; Development; Documentation; Economics; Effectiveness; Employment; Epidemic; Evaluation; Event; Food; Foundations; HIV; Health Insurance; Healthcare; Housing; Human; Hybrids; Individual; Infrastructure; Intervention; Intuition; Job Satisfaction; Maintenance; Mediating; Mental Health; Methods; Modeling; Morale; Outcome; Participant; Personal Satisfaction; Plant Roots; Prevention; Reach Effectiveness Adoption Implementation and Maintenance; Reporting; Resources; Services; Shelter facility; Social Work; Structure; Supervision; Support System; Supported Employment; Surveys; System; Testing; Time; Trainers Training; Training; Triad Acrylic Resin; Violence; Viral Load result; Vulnerable Populations; Work; aged; base; burnout; cost; design; effectiveness evaluation; effectiveness testing; effectiveness-implementation RCT; evidence base; experience; food security; hybrid type 2 trial; implementation evaluation; implementation framework; implementation outcomes; implementation strategy; improved; innovation; member; pre-exposure prophylaxis; prevent; sexual minority men; skills; substance use; transmission process

We will conduct a Hybrid Type II effectiveness-implementation randomized controlled trial of a Case Management Dyad (CM2) intervention, an evidence-based triadic social work intervention that uses a case manager dyad to engage younger Black sexual minority men (YBSMM) aged 18-35 in economic stability services. CM2 innovates on existing care continuum engagement models by (1) prioritizing resource counseling to improve HIV care and prevention continuum outcomes, and (2) utilizing a triadic network approach where a client meets with a dyadic case management team in tandem–forming a triad with the client–which provides additional supports for the client and the case managers. CM2 is timely given that intensive interventions are critical for engaging community members who have not benefited from existing Getting to Zero efforts. CM2 will also test robust implementation strategies to support CM2 implementation and to enhance the professional development and prevent burnout in the HIV front-line workforce, some of whom are directly impacted by HIV. The CM2 intervention and associated implementation strategies emerge from prior work conducted by the Investigative Team. We will build upon these experiences, infrastructures, and relationships to evaluate the effectiveness and implementation of CM2 among N=180 YBSMM. Data collection, at baseline, and every 6 months over 18 months, will include surveys and electronic medical record data. To study implementation, we will use the Consolidated Framework for Implementation Research as the determinant framework and RE-AIM as the evaluation framework. The specific aims are to: (Aim 1a) Evaluate the primary (financial well-being, food security) and secondary (integrated PrEP persistence/viral load suppression) effectiveness of CM2 vs routine Ryan White Non-Medical Case Management and PrEP Resource Counseling among YBSMM; (Aim 1b). Evaluate the effectiveness (time to successful resource referral completion, CM job satisfaction, CM burnout and CM-client relationship) of the CM2 intervention vs. routine Ryan White Case Management and/or PrEP Resource Counseling among case manager study participants; (Aim 2a) Determine the extent to which financial well-being and food security mediate the relationship between CM2 and downstream 18-month integrated care continuum outcomes; (Aim 2b) Explore potential differential effects of CM2 on primary (resource) and secondary (care continuum) outcomes, based on mental health, substance use, housing, employment and HIV serostatus; and (Aim 3) Evaluate implementation strategies and outcomes at both YBSMM and case manager levels using RE- AIM to study reach, adoption, implementation, and maintenance. Implementation strategies include individual and dyadic supervision, team consultation, and a train-the-trainer model, and implementation outcomes are acceptability, feasibility, appropriateness, feasibility, fidelity and cost. If successful, CM2 will intensify existing case management resource support systems, which will not only impact the lives and care continua of YBSMM, but also fulfill an ending the epidemic priority of revitalizing and sustaining the HIV frontline workforce.

我们将对一个病例进行一项混合II型有效性-实施随机对照试验。 管理二人组（CM 2）干预，一种基于证据的三元社会工作干预， 经理二人制，以吸引18-35岁的年轻黑人性少数群体男性（YBSMM）参与经济稳定 服务CM 2通过以下方式创新现有的护理连续体参与模式：（1）优先考虑资源咨询 改善艾滋病毒护理和预防连续性成果，以及（2）利用三元网络方法， 客户与一个串联的二元案例管理团队会面-与客户形成三位一体-这提供了 为客户和案件经理提供额外支持。CM 2是及时的，因为密集的干预措施 这对于吸引那些没有从现有的“零排放”努力中受益的社区成员至关重要。CM 2将 还测试了强大的实施策略，以支持CM 2的实施，并提高专业 发展和预防艾滋病毒前线工作人员的倦怠，其中一些人直接受到艾滋病毒的影响。 CM 2干预措施和相关的实施战略来自于 调查队。我们将在这些经验、基础设施和关系的基础上评估 在N=180个YBSMM中实施CM 2的有效性和实施情况。基线时和每6天收集一次数据 在18个月内，将包括调查和电子病历数据。为了研究执行情况，我们 我将使用实施研究的综合框架作为决定性框架， 作为评价框架。具体目标是：（目标1a）评估主要的（经济福利、食物） 安全性）和次要（综合PrEP持久性/病毒载量抑制）有效性 瑞安白色非医疗病例管理和YBSMM之间的PrEP资源咨询;（目标1b）。 评估有效性（成功完成资源转介的时间、CM工作满意度、CM倦怠和 CM-客户关系）与常规Ryan白色病例管理和/或PrEP资源 个案经理研究参与者之间的咨询;（目标2a）确定财务福祉 和粮食安全介导CM 2和下游18个月综合护理连续体之间的关系 结果;（目标2b）探索CM 2对初级（资源）和二级（护理）的潜在差异影响 （a）基于心理健康、药物使用、住房、就业和艾滋病毒血清状况的综合结果;以及 (Aim 3）使用RE-评估YBSMM和案例管理器级别的实施策略和结果 目的是研究到达，采用，实施和维护。实施战略包括个人 和二元监督，团队咨询，和培训的教练模式，和实施成果是 可接受性、可行性、适当性、可行性、忠实性和成本。如果成功，CM 2将加强现有的 病例管理资源支持系统，这不仅会影响YBSMM的生活和护理连续性， 而且还实现了结束流行病的优先事项，即振兴和维持艾滋病毒前线工作人员。