Scaling Up Implementation Strategies to Improve the DIAGNOSE and PREVENT Pillars for Young MSM in Florida

摘要 该项目将发起一个佛罗里达广泛的努力，以促进提供发展敏感，文化 适当的循证诊断和预防咨询检测和转诊服务（CTR）， 与男性发生性关系的年轻男性（YMSM）目标是利用实施科学战略， 提高艾滋病毒卫生部队提供循证实践的能力（减少风险咨询， PrEP转介和量身定制的动机面试）在CTR服务。我们最近的YMSM之谜 在三个城市的CTR站点进行的购物者研究表明，供应商没有做好准备， 不知道如何提供发展适当的，文化能力的CTR服务YMSM和小姐 提供这些循证实践的机会。Mystery Shopper是一种质量管理策略， 监测在合作减少风险环境中落实对文化和发展敏感的基本建设项目的忠实程度。然而，在这方面， 评估和反馈本身不足以提高忠诚度;卫生部队必须得到适当的培训 并提供技术援助。我们建议整合两个实施战略：质量管理 神秘购物者和健康力量培训在定制的动机面试与集中的技术 援助.我们将在佛罗里达的七个EHE测试以年轻人为中心的健康力量训练（YACHT）包 在卫生部的42个签约地点中，有24个县向至少24名年轻的MSM提供了CTR 在过去的12个月内使用阶梯楔形设计。我们对两种有效性结果（ YMSM的测试）和实施结果（基于神秘购物者评估的EBP保真度） 与2型混合试验一致。

Abstract This project will launch a Florida wide effort to promote the delivery of developmentally sensitive, culturally appropriate and evidence-based DIAGNOSE and PREVENT counseling testing and referral services (CTR) for young men who have sex with men (YMSM). The goal is to leverage implementation science strategies to improve the capacity of the HIV HealthForce to deliver evidence-based practices (risk reduction counseling, PrEP referral and Tailored Motivational Interviewing) within CTR services. Our recent YMSM Mystery Shoppers studies conducted at CTR sites in three cities indicated that providers are woefully unprepared or do not know how to deliver developmentally appropriate, culturally competent CTR services to YMSM and miss opportunities to deliver these evidence-based practices. Mystery Shopper is a quality management strategy to monitor implementation fidelity to culturally and developmentally responsive EBPs in CTR settings. However, assessment and feedback alone are insufficient to improve fidelity; the HealthForce must be properly trained and given technical assistance. We propose integrating two implementation strategies: quality management Mystery Shoppers and HealthForce training in Tailored Motivational Interviewing with centralized technical assistance. We will test Young Adult Centered HealthForce Training (YACHT) package in Florida’s seven EHE counties among the Department of Health’s 42 contracted sites who delivered CTR to at least 24 young MSM in the previous 12 months using a Stepped Wedge design. We power on both effectiveness outcomes (# of tests of YMSM) and implementation outcomes (EBP fidelity based on Mystery Shopper Assessments) consistent with a Type 2 Hybrid trial.