Adaptation and optimization of the Friendship Bench mental health intervention for adolescent girls and young women in South African PrEP delivery settings

南非 PrEP 分娩环境中针对少女和年轻女性的友谊长凳心理健康干预的调整和优化

• 批准号: 10550017
• 负责人: Jennifer Velloza
• 金额: $ 24.9万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-11 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10550017
• 关键词: AIDS prevention; Accounting; Address; Adherence; Africa South of the Sahara; African; Age; Anxiety; Award; Behavioral; Behavioral Sciences; Characteristics; Clinic; Communities; Complex; Consolidated Framework for Implementation Research; Counseling; Data; Development; Discrimination; Educational workshop; Effectiveness; Ensure; Epidemiologist; Epidemiology; Face; Feedback; Female Adolescents; Friendships; Goals; HIV; Health; Health Priorities; Healthcare; High Risk Woman; Human immunodeficiency virus test; Incidence; Individual; Intervention; Interview; Link; Manuals; Measures; Mental Depression; Mental Health; Mental Health Services; Mental disorders; Mentors; Outcome; Perception; Persons; Pharmaceutical Preparations; Population; Postdoctoral Fellow; Prevention approach; Process; Publishing; Randomized; Reproductive Health; Research; Research Personnel; Risk; Scientist; Services; South Africa; South African; Specific qualifier value; Stress; Surveys; Symptoms; Testing; Therapeutic Intervention; Training; Training Support; Universities; Washington; Woman; Work; Youth; Zimbabwe; adolescent health outcomes; base; career; common symptom; coping; cost; design; effectiveness evaluation; effectiveness implementation study; effectiveness implementation trial; evidence base; experience; gender-based violence; health care delivery; human centered design; hybrid type 2 trial; implementation barriers; implementation cost; implementation science; implementation strategy; improved; innovation; insight; intervention effect; meetings; multidisciplinary; persistent symptom; pre-exposure prophylaxis; preference; prevention service; problem solving therapy; programs; prototype; psychologic; scale up; service delivery; social stigma; standard of care; therapy design; tool; treatment adherence; treatment arm; young woman

ABSTRACT The goal of the proposed K99/R00 award is to support Dr. Jennifer Velloza’s development into an independent HIV and mental health researcher, with a focus on improving delivery of mental health interventions integrated with HIV prevention services for young women. Dr. Velloza is an epidemiologist and postdoctoral fellow at the University of Washington. This proposal outlines a 5-year training and research plan to build her capacity with formal training in human-centered design and implementation science. Training Plan: To ensure transition to independence, Dr. Velloza has assembled a multidisciplinary team of mentors and advisors with expertise in human-centered design, implementation science, and PrEP and mental health service delivery for South African adolescent girls and young women (AGYW). They have crafted a robust training plan with meetings and relevant coursework. The training goals for the K99 are to: 1) Gain proficiency in human-centered design for intervention adaptation; 2) Apply implementation science tools to identify implementation strategies for integrating a mental health intervention in PrEP delivery; and 3) Transition to independence by leading a trial to test and optimize a mental health intervention for South African AGYW in PrEP settings. These goals build on her prior experience and training and support her long-term career goals. Research Plan: African AGYW face high rates of HIV and common mental disorders. PrEP is a highly effective HIV prevention approach which is being scaled up in South Africa. However, symptoms of common mental disorders are significant barriers to PrEP use and the South African Department of Health is placing increasing emphasis on layered approaches to PrEP delivery for AGYW. Effective mental health treatment, such as problem-solving therapy (PST), has the potential to be integrated with PrEP delivery to address mental health challenges and modifiable barriers to PrEP use and improve PrEP adherence for AGYW. The Friendship Bench is a promising evidence-based PST intervention option for AGYW in PrEP settings given that it was developed for delivery in busy HIV clinics, is currently being scaled-up in South Africa, and preliminary data suggests it can be adapted to improve HIV treatment adherence among African women. Research is needed to adapt intervention content, evaluate effectiveness on mental health and PrEP adherence outcomes, and identify implementation strategies for AGYW in PrEP delivery settings. The overall goal of this proposal is to adapt, test, and optimize the Friendship Bench for African AGYW in PrEP delivery. The Specific Aims are to: 1) Identify content for a mental health intervention and barriers to implementation in PrEP clinics; 2) Design and pilot Youth Friendship Bench SA content and implementation strategies; 3) Conduct a hybrid Type II trial to assess preliminary effectiveness of Youth Friendship Bench SA on PrEP adherence while optimizing implementation for cost constraints in PrEP delivery; and 4) Identify themes around intervention experiences. These aims correspond with Dr. Velloza’s training goals and she will emerge as an independent scientist contributing to high priority issues around mental health and HIV prevention service delivery.

摘要