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.

摘要 - Bon Bagay（好东西）：海地后裔的艾滋病毒生物医学预防 艾滋病毒是一种慢性疾病。佛罗里达州迈阿密市是美国艾滋病毒发病率最高的城市之一 1 迈阿密之前的数据显示，海地出生的人占艾滋病毒报告总数的 11% 例，尽管仅占总人口的 4.4%。2 艾滋病毒感染率差异的一个可能原因是 居住在迈阿密的海地人后裔缺乏获得或接受艾滋病毒预防服务的机会。3 暴露预防 (PrEP) 是预防新发 HIV 感染的有效方法。 4 然而， PrEP 使用方面的差异。美国有艾滋病毒风险的黑人无法获得这些药物，因为 与白人同龄人一样频繁使用 5，并且在海地血统的人中使用 PrEP 的情况甚至更少。 之前的研究是在迈阿密针对感染艾滋病毒的海地裔人群进行的，然而，这些 研究未包括 HIV 生物医学预防策略，例如 PrEP.6,7 开展的初步工作 Sternberg 博士（Bon Sante 或良好健康研究）发现人们对 PrEP 的使用有浓厚的兴趣，但缺乏 文化上适当且易于获得的 PrEP 服务。8 此外，教堂作为 PrEP 信息和传播途径 注意到了潜在的交付。8 该应用程序的目标是： 目标 1：描述 PrEP 实施的环境和组织决定因素， 为迈阿密海地人后裔服务的教堂的可持续发展。理由：文化发展 克服海地人民现有差距（PrEP 吸收）的相关实施方法 血统，了解教会的组织文化、管理支持和目标至关重要 为大众服务，重点是 PrEP 的提供。方法：本研究将使用以情境为中心的方法 到实施，实用、稳健的实施和可持续性模型 (PRISM)。9 本研究将使用 棱镜评估教会的观点。我们将通过开展焦点小组活动来关注交付的背景 与领导者、经理和员工。我们将利用迈阿密已建立的社区合作伙伴关系（海地 美国专业人士联盟）招募焦点小组参与者。将使用三个焦点小组进行 半结构化访谈指南并将使用定性分析进行分析。结果：从这个目标出发，我们 将进一步了解教会的需求和有效实施 PrEP 的决定因素。 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对各种方面的偏好 服务和产品，包括 PrEP10。我们将使用这种方法对 PrEP 交付的偏好进行排名 迈阿密去教堂的海地人后裔中的典型。方法：我们将进行离散 对 120 名居住在迈阿密的海地人后裔参加教堂进行选择实验，以评估偏好 关键属性之中。结果：通过这个过程，我们将获得描述关键问题的定量发现 PrEP 的理想属性及其为参加教堂的海地社区成员提供的服务。