Midwest TXTXT: Scale up of an Evidence-Based Intervention to Promote HIV Medication Adherence

项目摘要 在本申请中，我们建议通过创建区域中心来扩大循证干预措施- TXTXT 在中西部，协调广泛的传播，并大大增加覆盖面和影响力。我们将评估 通过混合型II设计实施EBI扩展，以广泛传播 基于区域的实施模式，并将制定TXTXT的可持续发展计划，以告知大规模 传播和快速扩展到其他美国地区。 具体目标： 1.确定EBI- TXTXT-在我们的初级和初级产品上的区域性扩展的真实效果， 次要结局：依从性、病毒载量抑制和保留HIV护理， 粘附性较差的少数种族/民族YLH，3个月和6个月随访时年龄为16-35岁。 2.应用实施研究综合框架（CFIR）描述实施情况 处理并确定需要解决的障碍和促进因素;并衡量执行情况 使用RE-AIM框架的TXTXT干预的结果（达到，有效性，采用， 执行、维护）。 博士约翰逊是一个以艾滋病毒为重点的实施科学导师奖的理想候选人。她是一个 受过培训的传染病流行病学家，具有实施科学方法的初步认证， 方法（尚未应用）。作为一名早期的艾滋病预防科学家，她有一种经验， 源于社区参与的研究，包括基础科学，包括监测和 流行病学以及干预发展和能力发展举措。下一个逻辑步骤是 获得系统级实施科学和可持续性规划方面的技能，以广泛传播信息 基于证据的干预措施。这项研究结合了行为和社会科学，实施科学， 和信息传播的最终目标，对公众健康的影响。药物依从性是关键 病毒抑制的驱动程序和这个区域TXTXT倡议，与国家的长期目标， 传播和集中于病毒学失败风险最大的患者将直接解决当地、区域和 到2030年结束流行病的国家目标。

PROJECT SUMMARY ABSTRACT In this application, we propose to scale up an Evidence-Based Intervention- TXTXT- by creating a regional hub in the Midwest to coordinate broad dissemination, and to greatly increase reach and impact. We will evaluate the implementation of the EBI scale up via a hybrid type II design to inform the broad dissemination of a region-based implementation model and will elaborate a sustainability plan for TXTXT to inform wide scale dissemination and rapid scale up to additional US regions. Specific Aims: 1. Determine the real-world efficacy of a regional scale up of an EBI- TXTXT- on our primary and secondary outcomes: adherence, viral load suppression, and retention in HIV care, respectively, among poorly adherent racial/ethnic minority YLH, ages 16-35 at 3-and 6-month follow-up. 2. Apply the Consolidated Framework for Implementation Research (CFIR) to describe the implementation process and identify barriers and facilitators needed to be addressed; and measure implementation outcomes of the TXTXT intervention using the RE-AIM framework (Reach, Efficacy, Adoption, Implementation, Maintenance). Dr. Johnson is an ideal candidate for an HIV-focused Implementation Science mentorship award. She is a trained Infectious Disease Epidemiologist with initial certification in Implementation Science approaches and methods (not yet applied). As an early career HIV prevention scientist, she has a breath of experience that stems from community-engaged research which includes basic science, including surveillance and epidemiology as well as intervention development and capacity development initiatives. The next logical step is to gain skills in systems-level implementation science and sustainability planning to inform broad dissemination of evidence-based interventions. This study combines behavioral and social science, implementation science, and information dissemination towards the ultimate goal of public health impact. Medication adherence is a key driver of viral suppression and this regional TXTXT initiative, with a longer-term objective of national dissemination and focused on patients at most risk of virologic failure will directly address local, regional and national goals to End the Epidemic by 2030.