Start the conversation: A multi-level PrEP initiative for Black women in NOLA

开始对话：针对诺拉黑人女性的多层次 PrEP 倡议

• 批准号: 10403104
• 负责人: Meredith Edwards Clement
• 金额: $ 29.98万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-20 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10403104
• 关键词: Address; Administrative Supplement; Adoption; Advisory Committees; Awareness; Black race; Caring; Clinic; Communities; Educational Curriculum; Epidemic; Evaluation; Feedback; Focus Groups; Funding; Grant; Gynecology; HIV; HIV Infections; HIV diagnosis; Health; Health Services Accessibility; Interview; Link; Location; Louisiana; Maintenance; Measures; Media Campaign; Medical; Methods; Modeling; Outcome; Patients; Provider; Research; Research Personnel; Research Proposals; Residencies; Sexual Health; Site; Stress; Testing; Time; Training; Training Programs; United States National Institutes of Health; Universities; Woman; base; black women; care outcomes; cis-female; design; effectiveness measure; experience; follow-up; health disparity; implementation evaluation; implementation outcomes; implementation research; implementation science; implementation strategy; improved; interest; member; pre-exposure prophylaxis; programs; shared decision making; sharing platform; social media; social networking website; uptake; working group

PROJECT SUMMARY The rate of HIV diagnosis among Black cisgender women in Louisiana is almost 7 times higher than of White cisgender women. Multi-level implementation strategies are critically needed to reduce HIV infections among Black cisgender women in New Orleans, Louisiana (NOLA), an Ending the Epidemic priority jurisdiction. Using findings from our recently-conducted qualitative interviews with Black cisgender women and contributions from NOLA’s Black Women and PrEP Task Force, we have identified two main barriers that limit PrEP uptake among Black cisgender women in NOLA: (1) Black cisgender women do not know of other Black cisgender women taking PrEP, and (2) Black cisgender women are not offered PrEP during routine medical care. To address these determinants, we propose to develop and pilot a Start the Conversation Initiative that includes implementation strategies at the patient and provider levels. Aim 1 focuses on developing the patient-level implementation strategy, a social media campaign. Working with the Black Women and PrEP Task Force and a local community-based organization that specializes in social media campaigns, we will determine the content of the social media messages and the type of social media to use. We will conduct 4 focus group discussions with Black cisgender women to pre-test the social media content. Aim 2 focuses on developing the provider-level implementation strategies. We will develop a combined-care PrEP model that encourages GYN residents to (1) start a PrEP conversation with their patients and help them to determine if PrEP is right for them, and (2) help their patients to determine the best location of PrEP follow-up—either with the GYN residency clinic or with a routine PrEP provider. We will conduct 12 in-depth interviews (IDIs) with GYN and routine PrEP providers and establish a working group of GYN residents, GYN residency directors, and current PrEP providers to inform the combined-care PrEP model. In Aim 3, we will evaluate the implementation of the Start the Conversation Initiative. We will pilot the strategies at the Louisiana State University (LSU) GYN residency program over an 8-month period to inform acceptability, feasibility and potential impact. We will first implement the provider-level strategies, then layer in the patient-level strategies to examine impact on patient demand (PrEP uptake) and retention. The 8 months of combined implementation will be compared to PrEP uptake from a comparison GYN clinic at Tulane; one month retention in care outcomes will be measured at LSU. Implementation outcomes (adoption, fidelity, maintenance) will be assessed through chart review and triangulated with resident feedback sessions. We will also conduct 24 IDIs each with providers (n=12) and patients (n=12) to further inform acceptability, feasibility and appropriateness. At the end of the R34, we plan to submit a larger implementation research proposal with additional sites in the U.S. South to evaluate these optimized community-identified implementation strategies.

项目摘要 路易斯安那州黑色sisgender妇女的艾滋病毒诊断率几乎是白人的7倍 赋予妇女。迫切需要多层实施策略来减少艾滋病毒感染 路易斯安那州新奥尔良（NOLA）的黑人妇女，终止流行病优先管辖权。使用 我们最近对黑人妇女的定性采访的调查结果以及 诺拉（Nola）的黑人妇女和准备工作队 在诺拉的黑色sisgender妇女中：（1）黑色sisgender妇女不知道其他黑色sisgender 服用准备的妇女，（2）在例行医疗保健期间，未提供黑色scisgender妇女。到 解决这些决定者，我们建议开发和驾驶包括包括的对话计划 患者和提供者级别的实施策略。 AIM 1专注于开发患者级别 实施策略，社交媒体运动。与黑人妇女和准备工作队一起工作 一个专门从事社交媒体运动的本地社区组织，我们将确定 社交媒体信息的内容和要使用的社交媒体类型。我们将进行4个焦点小组 与黑人cisgender妇女进行讨论，以预测试社交媒体内容。 AIM 2专注于开发 提供者级实施策略。我们将开发一种综合护理准备模型，以鼓励GYN （1）居民与患者开始准备对话，并帮助他们确定准备是否适合 他们和（2）帮助他们的患者确定PREP随访的最佳位置 - 居住诊所或与常规预备提供者。我们将对Gyn和Gyn进行12次深入访谈（IDI） 常规准备提供者并建立一个由妇科妇女，妇科妇女司法部董事和当前的工作组 准备提供者为合并的预备模型提供通知。在AIM 3中，我们将评估实施 开始对话计划。我们将在路易斯安那州立大学（LSU）GYN的策略中驾驶策略 在一个8个月的时间内，长期计划为可接受性，可行性和潜在影响提供信息。我们将首先 实施提供商级策略，然后在患者级策略中分层以检查对患者的影响 需求（预先吸收）和保留。将8个月的合并实施与PREP进行比较 来自图兰的Gyn诊所的吸收；一个月保留护理结果的保留率将在 LSU。实施结果（采用，忠诚，维护）将通过图表审查评估， 由居民反馈会议进行三角剖分。我们还将与提供者（n = 12）一起进行24个IDI，并且 患者（n = 12）进一步为可接受性，可行性和适当性提供信息。在R34结束时，我们计划 在美国南部的其他站点提交更大的实施研究建议，以评估这些建议 优化社区确定的实施策略。