Accelerating Equitable PrEP Delivery for Black Adults in Primary Care Settings: Development and Testing of A Practice-Level Multifaceted Implementation Strategy

加快初级保健机构中黑人成人的公平 PrEP 实施:制定和测试实践层面的多方面实施策略

基本信息

  • 批准号:
    10761903
  • 负责人:
  • 金额:
    $ 19.49万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2023
  • 资助国家:
    美国
  • 起止时间:
    2023-06-16 至 2028-05-31
  • 项目状态:
    未结题

项目摘要

PROJECT SUMMARY/ABSTRACT Substantial measures must be taken in the United States to rectify the marked inequities in HIV pre-exposure prophylaxis (PrEP) outcomes among Black adults. PrEP implementation among Black populations is undermined by individual, interpersonal, and structural barriers rooted in stigma, racism, heterosexism, and sexism. Improving PrEP provision has become imperative as novel modalities emerge. There is an urgent need to develop implementation strategies that accelerate equitable PrEP delivery. The goal of this K23 is to facilitate Dr. Watson’s long-term goal to become an independent investigator focused on the development of implementation strategies to achieve equitable HIV prevention outcomes among Black populations. The proposed K23 will focus on designing and testing a multifaceted implementation strategy to support PrEP provision for Black primary care patients, grounded in an adapted conceptual framework that includes constructs from the Consolidated Framework for Implementation Research (CFIR) and Bandura’s Social Cognitive Theory. Dr. Watson’s proposed research plan will consist of training objectives in (1) qualitative research, (2) behavioral and social science research (BSSR), (3) community-engaged research, and (4) implementation science. With a focus on equity-centered applications within implementation science and community-engaged research, she requires further training in qualitative research, BSSR, and trial design to develop and pilot an implementation strategy to increase local PrEP provision capacity. These training objectives will be achieved through mentorship from an exemplary multidisciplinary mentorship team, complementary research aims, professional development activities, and coursework. Specifically, she plans to: (Aim 1) Identify key provider-, practice-, and community-level CFIR- based determinants of local PrEP delivery; (Aim 2) Develop a theory-informed multifaceted implementation strategy that follows a destigmatizing sexual health framework to accelerate equitable PrEP delivery for adult Black primary care patients; (Aim 3) Conduct a 12-month two-arm pilot trial to evaluate implementation strategy feasibility and acceptability at four medical practices that provide primary care services. The results of this study will be important for the field of implementation science as it focuses on facilitating theory- informed behavior changes among providers and practice leadership to accelerate equitable PrEP provision for Black primary care patients. Findings from the pilot will inform the design and submission of an R01 application for a hybrid effectiveness-implementation trial of the implementation strategy in year 4. The proposal will form a strong foundation for Dr. Watson’s continued development toward an independently funded research career as an implementation scientist invested in the development of implementation strategies to achieve equitable HIV prevention care outcomes among Black adults in the U.S.
项目总结/摘要 美国必须采取实质性措施来纠正艾滋病毒暴露前的明显不平等 预防性(PrEP)在黑人成年人中的结果。在黑人人口中实施PrEP是 被根植于污名、种族主义、异性恋和性别歧视的个人、人际和结构性障碍所破坏, 性别歧视随着新模式的出现,改善PrEP的提供已变得势在必行。目前迫切 需要制定实施战略,加快公平的PrEP交付。K23的目标是 促进沃森博士的长期目标,成为一个独立的调查员,专注于 制定实施战略,在黑人中实现公平的艾滋病毒预防成果 人口。拟议的K23将侧重于设计和测试多方面的实施战略 支持为黑人初级保健患者提供PrEP,以适应性概念框架为基础 其中包括实施研究综合框架(CFIR)的结构, 班杜拉的社会认知理论沃森博士提出的研究计划将包括培训目标 在(1)定性研究,(2)行为和社会科学研究(BSSR),(3)社区参与 研究;(4)实施科学。专注于以股权为中心的应用程序, 实施科学和社区参与的研究,她需要进一步培训,在定性 研究,BSSR和试验设计,以制定和试行实施战略,以增加当地的PrEP 提供能力。这些培训目标将通过一个示范性的指导来实现。 多学科导师团队,互补的研究目标,专业发展活动,以及 课程作业具体而言,她计划:(目标1)确定关键的提供者,实践和社区一级的CFIR- 基于当地PrEP提供的决定因素;(目标2)制定理论知情的多方面实施 遵循消除污名化性健康框架的战略,以加速公平的PrEP交付, 成年黑人初级保健患者;(目标3)进行为期12个月的两组试点试验,以评估实施情况 战略的可行性和可接受性在四个医疗实践提供初级保健服务。结果 这项研究将是重要的实施科学领域,因为它侧重于促进理论- 提供者和实践领导之间的知情行为变化,以加速公平的PrEP提供 黑人初级保健患者。试点的结果将为R 01的设计和提交提供信息 申请在第4年对执行战略进行混合有效性-执行试验。的 该提案将为沃森博士继续向独立发展奠定坚实的基础。 作为实施科学家,投资于实施的发展, 在美国黑人成年人中实现公平的艾滋病毒预防保健结果的战略

项目成果

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