Scientific Core (ETR)

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The implementation science literature underscores the challenges associated with moving research to routine practice, and acknowledges the importance of building the literature base to facilitate scale-up of evidence- based practices. In our proposed U19, our interdisciplinary research team is committed to working with HIV+ youth and youth at risk of infection to improve their health and well-being and to develop the IS field by employing three types of effectiveness-implementation hybrid designs, all addressing self-management: 1) a Type 1 design (Belzer and Brown) in which the primary aim is to determine the effectiveness of clinical intervention with a secondary aim to better understand the context for implementation; 2) a Type 2 design (Parsons) in which the primary aims are to determine both the effectiveness of the clinical intervention and the feasibility and utility of an implementation strategy; and 3) a Type 3 design (Naar), in which the primary aim is to determine the utility of an implementation strategy with a secondary aim on assessing effectiveness on cascade-related outcomes. Consistent with our overall goal of advancing implementation science, our team has established an Implementation Science Core (ISC) to maximize efficiencies across projects and has adopted an implementation conceptual model, Exploration-Preparation-Implementation-Sustainment (EPIS), to ground implementation planning, research, and measurement across the studies. In particular, the Research Projects will examine EPIS inner and outer context factors across phases—from exploring ways to improve fit to characteristics that may influence active implementation, such as the sociopolitical context, leadership, facilitator attitudes toward evidence-based practices, fiscal viability, and acceptability and feasibility of interventions. Specifically, the ISC will: (1) facilitate and support a unified approach to implementation science research particularly as it applies to self-management by HIV+ or at risk youth; (2) provide resources to support early career and other investigators in the newly developed ATN4 with implementation science issues related to their studies; and (3) increase dissemination of interventions, support materials, and implementation study findings relevant to adolescent HIV/AIDS prevention and treatment. The inclusion of the ISC provides an opportunity for synergy across Research Projects to systematically expand the implementation science research related to youth HIV self-management interventions, a contribution to field and to those looking towards avenues of scaling up such interventions.