Integrating Status-Neutral Linkage to Services in Behavioral Health Organizations

项目总结/摘要 为了实现到2030年减少新增艾滋病毒感染的终止艾滋病毒流行（EHE）目标，金县 西澳大利亚州必须改进其计划，以接触行为健康障碍的个人。县监测数据显示， 自2018年以来，精神障碍和物质使用障碍在新的艾滋病毒感染者中的比例非常高。 研究表明，患有严重精神疾病的人（如 精神分裂症和双相情感障碍）至少是一般人群的四倍，但这些人 个人的检测不一致，并且经常在艾滋病毒筛查工作中被遗漏。大多数人与美国 患有严重精神疾病的人通过他们的精神健康提供者进入医疗保健系统， 在社区精神卫生机构中，筛查和预防服务的普及率很低。本研究的目的是 提高金郡行为健康组织提供快速艾滋病毒检测的能力， 与经证实的预防服务（接触前预防和注射器服务方案， 金郡EHE计划预防支柱的重点），以减少金郡的艾滋病毒发病率。当前EHE 努力包括学习协作-一种广泛使用的实施战略，以支持实施 新的服务或改善护理-增加艾滋病毒检测和与急诊部门服务的联系， 初级保健诊所。目前为期一年的提案旨在制定EHE协作计划，以支持 行为健康组织，以增加获得艾滋病毒检测和连接的服务，其中一个关键 目前EHE工作没有覆盖的人口。我们建议确定艾滋病毒的最佳做法 预防服务以及对艾滋病毒服务采取不分地位的做法的障碍和促进因素。我们 将采用混合方法，从服务清单中收集定量数据， 由金郡行为健康25个成员组织的负责人完成的资源 提供者协会和定性数据，通过深入采访45个人谁代表关键 利益相关者团体努力改善行为健康组织的艾滋病毒预防服务。这 该提案利用了一个独特的机会，在现有的EHE上进行严格的实施科学研究 活动，以产生关于如何在行为健康方面建立艾滋病毒预防能力的知识， 组织以及如何评估EHE学习协作。在提案的最后，我们将有一个 为行为健康组织量身定制的EHE协作，我们将在随后的 执行试验。

PROJECT SUMMARY/ABSTRACT To reach the Ending the HIV Epidemic (EHE) targets for reducing new HIV infections by 2030, King County WA must improve its plan to reach individuals with behavioral health disorders. County surveillance data reveal very high rates of mental disorders and substance use disorder among new HIV infections since 2018. Research has demonstrated that the HIV prevalence among people with serious mental illnesses (such as schizophrenia and bipolar disorder) is at least four times that of the general population, but that these individuals are inconsistently tested and often missed through HIV screening efforts. Most people with the US who have serious mental illness access the healthcare system through their mental health provider, but rates of screening and prevention services are low in community mental health settings. The goal of this research is to increase the capacity of King County behavioral health organizations to provide rapid HIV testing and linkage to proven prevention services (pre-exposure prophylaxis and syringe services programs that are the focus of the Prevent Pillar of the King County EHE plan) to reduce HIV incidence in King County. Current EHE efforts include Learning Collaboratives--a widely-used implementation strategy to support implementation of new services or improve care—to increase HIV testing and linkage to services in emergency departments and primary care clinics. The current one-year proposal aims to develop an EHE Collaborative to support behavioral health organizations to increase access to HIV testing and linkage to services among a critical population that is not being reached by current EHE efforts. We propose to identify best practices for HIV prevention services and barriers and facilitators to implementing a status neutral approach to HIV services. We will utilize a mixed methods approach, collecting both quantitative data from an inventory of services and resources completed by directors of the 25 member organizations of the King County Behavioral Health Provider Association and qualitative data through in-depth interviews of 45 individuals who represent key stakeholder groups in efforts to improve HIV prevention services in behavioral health organizations. This proposal leverages a unique opportunity to layer rigorous implementation science research on existing EHE activities, to generate knowledge both about how to build HIV prevention capacity in behavioral health organizations and how to evaluate EHE Learning Collaboratives. At the end of the proposal, we will have a tailored EHE Collaborative for Behavioral Health organizations which we will test in a subsequent implementation trial.