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 拟议的K99/R 00奖的目标是支持詹妮弗Velloza博士的发展成为一个独立的 艾滋病毒和心理健康研究员，重点是改善综合心理健康干预措施的提供 为年轻女性提供艾滋病毒预防服务。Velloza博士是一位流行病学家和博士后研究员， 华盛顿大学。该提案概述了一项为期5年的培训和研究计划，以建立她的能力， 以人为本的设计和实施科学的正式培训。培训计划：确保过渡到 独立性，Velloza博士组建了一个多学科的导师和顾问团队，具有以下方面的专业知识： 以人为本的设计，实施科学，为南非提供PrEP和心理健康服务 少女和年轻妇女。他们精心制定了一个强有力的培训计划， 课程作业K99的培训目标是：1）熟练掌握以人为本的干预设计 2）应用实施科学工具，以确定实施战略， PrEP提供中的健康干预;以及3）通过领导一项试验来测试和优化 在PrEP环境中为南非AGYW提供心理健康干预。这些目标建立在她以前的经验基础上 培训和支持她的长期职业目标。研究计划：非洲AGYW面临高艾滋病毒感染率， 常见的精神障碍PrEP是一种非常有效的艾滋病毒预防方法，正在南方推广 非洲然而，常见精神障碍的症状是使用PrEP的重大障碍， 非洲卫生部越来越重视为AGYW提供PrEP的分层方法。 有效的心理健康治疗，如问题解决疗法（PST），有可能与 提供PrEP，以应对心理健康挑战和PrEP使用的可改变障碍，并改善PrEP 坚持以德为先。友谊长凳是AGYW的一种有前途的循证PST干预选择 鉴于该方案是为在忙碌的艾滋病毒诊所提供服务而开发的，目前正在南方扩大 初步数据表明，它可以用于改善非洲艾滋病毒治疗的依从性。 妇女需要进行研究以调整干预内容，评估心理健康和PrEP的有效性 依从性结果，并确定在PrEP交付环境中AGYW的实施策略。整体 本提案的目标是调整、测试和优化非洲AGYW在PrEP交付方面的友谊平台。 具体目标是：1）确定心理健康干预的内容和实施障碍， PrEP诊所; 2）设计和试点青年友谊长凳SA内容和实施战略; 3）开展 一项混合II型试验，评估青年友谊长凳SA对PrEP依从性的初步有效性， 优化实施PrEP交付中的成本限制;以及4）确定围绕干预的主题 经验这些目标符合Velloza博士的培训目标，她将成为一个独立的 科学家为精神健康和艾滋病毒预防服务提供方面的高度优先问题做出贡献。