Southeast Collaborative for Innovative and Equitable Solutions to Chronic Disease Disparities

东南合作以创新和公平的方式解决慢性病差异

• 批准号: 10604586
• 负责人: Nancy J Cox
• 金额: $ 31.91万
• 依托单位: VANDERBILT UNIVERSITY MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-24 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10604586
• 关键词: AIDS prevention; American; Black Populations; Chronic Disease; Church; Cities; Communities; Data; Florida; Focus Groups; Goals; HIV; HIV Infections; Haitian; Health; Incidence; Individual; Interview; Methods; Organizational Culture; Outcome; Participant; Persons; Pharmaceutical Preparations; Population; Practical Robust Implementation and Sustainability Model; Prevention strategy; Preventive service; Process; Reporting; Research; Risk; Services; Structure; United States; Work; community partnership; disease disparity; experimental study; innovation; interest; member; pre-exposure prophylaxis; preference; prevent; recruit; uptake

SUMMARY- Bon Bagay (Good Stuff): Biomedical HIV Prevention Among People of Haitian Descent HIV is a chronic disease. The city of Miami, Florida has one of the highest incidence rates of HIV in the United States.1 Previous data from Miami showed that Haitian-born people represented 11% of the total reported HIV cases, despite comprising only 4.4% of the population.2 A likely cause for the disparity in HIV incidence among people of Haitian descent living in Miami is a lack of access to or uptake of HIV-preventive services.3 Pre- exposure prophylaxis (PrEP) is an effective method to prevent new HIV infections.4 There are, however, vast disparities in PrEP utilization. Black individuals in the US at risk for HIV are not accessing these medications as frequently as their White counterparts,5 and PrEP use is even less common among people of Haitian descent. Previous research was conducted in Miami, among people of Haitian descent living with HIV, however, these studies have not included biomedical HIV prevention strategies such as PrEP.6,7 Preliminary work conducted by Dr. Sternberg, (the Bon Sante or Good Health study), identified a strong interest in PrEP use but a lack of culturally appropriate and accessible PrEP services.8 In addition, churches as avenues for PrEP information and potentially delivery was noted.8 The aims for this application are: Aim 1: To characterize contextual and organizational determinants of PrEP implementation and sustainability at churches serving people of Haitian descent in Miami. Rationale: In developing culturally relevant implementation approaches that overcome existing gaps (PrEP uptake) among people of Haitian descent, it is critical to understand the organizational culture, management support, and goals of churches serving the population, with a focus on PrEP delivery. Approach: This study will use a context-focused approach to implementation, the Practical, Robust Implementation and Sustainability Model (PRISM).9 This study will use PRISM to assess the churches' perspectives. We will focus on the context of delivery by conducting focus groups with leaders, managers, and staff. We will use an established community partnership in Miami (the Haitian American Professionals Coalition) to recruit focus group participants. Three focus groups will be conducted using semi-structured interview guides and will be analyzed using qualitative analysis. Outcome: From this aim, we will have a further understanding of the churches' needs and determinants for effective PrEP delivery. Aim 2: To quantify key preferences for PrEP among people of Haitian descent. Rationale: Discrete choice experiments have been widely used to further understand individual preferences regarding a wide range of services and products, including PrEP10. We will use this approach to rank preferences regarding PrEP delivery and type among people of Haitian descent in Miami attending church. Approach: We will conduct a discrete choice experiment among 120 people of Haitian descent living in Miami attending church to assess preferences among key attributes. Outcome: Through this process, we will have a quantitative finding describing critical desirable attributes of PrEP and its provision for members of the Haitian community who attend church.

Bon Bagay（好东西）：海地人后裔中的生物医学艾滋病毒预防 艾滋病毒是一种慢性疾病。佛罗里达的迈阿密市是美国艾滋病发病率最高的城市之一。 1以前来自迈阿密的数据显示，海地出生的人占报告的艾滋病毒感染者总数的11 艾滋病毒感染率差异的一个可能原因是， 生活在迈阿密的海地裔人缺乏获得或接受艾滋病毒预防服务的机会。 暴露预防（PrEP）是预防新的HIV感染的有效方法。 PrEP利用率的差异。美国有艾滋病毒风险的黑人无法获得这些药物， 海地人后裔中使用PrEP的情况更不常见。 以前的研究是在迈阿密进行的，在海地血统的艾滋病毒感染者中进行的，然而， 研究没有包括生物医学艾滋病毒预防战略，如PrEP。 博士斯滕贝格（Bon Sante或良好健康研究）确定了对PrEP使用的强烈兴趣，但缺乏 8此外，教堂作为PrEP信息的渠道， 8这项申请的目的是： 目标1：描述PrEP实施的背景和组织决定因素， 在迈阿密为海地人后裔服务的教堂中开展可持续性活动。理由：在发展文化方面 克服海地人民之间现有差距的相关实施办法（预防性预防措施的采用） 因此，了解教会的组织文化、管理支持和目标至关重要。 服务人群，重点是PrEP交付。方法：本研究将采用注重背景的方法 本研究将采用实用、稳健的实施和可持续性模式（PRISM）。 PRISM评估教会的观点。我们将通过举办焦点小组讨论会， 与领导者、经理和员工的沟通。我们将利用在迈阿密（海地）建立的社区伙伴关系 美国专业人士联盟）招募焦点小组参与者。三个焦点小组将使用 半结构化面试指南，并将使用定性分析进行分析。结果：从这一目标出发，我们 将有教会的需求和有效的PrEP交付的决定因素的进一步了解。 目标2：量化海地人后裔对PrEP的主要偏好。理由：离散选择 实验已被广泛用于进一步了解个人偏好， 服务和产品，包括PrEP 10。我们将使用这种方法对PrEP交付的偏好进行排名 在迈阿密的海地人后裔中做礼拜。方法：我们将进行离散 在120名居住在迈阿密的海地后裔中进行的选择实验，参加教堂活动，以评估偏好 在关键属性中。结果：通过这一过程，我们将有一个定量的发现，描述关键的 PrEP的理想属性及其为参加教会的海地社区成员提供的服务。