R01NR021692

Cluster randomized controlled trial of using PrEP, doing it for ourselves [UPDOS] protective styles: A salon-based intervention to improve PrEP uptake among Black cis-gender women.

HIV disproportionately affects Black cisgender women living in the United States South, threatening progress toward the Ending the HIV Endemic Initiative's 2030 goals.

Although pre-exposure prophylaxis (PrEP), an oral or injectable medication that if taken is highly effective in preventing HIV, Black cisgender women have not equitably benefited from its use due to multiple complex factors.

For example, lack of awareness and knowledge to PrEP, not trusting PrEP, PrEP stigma, providers not knowing about or offering PrEP, accessibility, and cost.

These factors all contribute to only 2% of eligible women taking PrEP.

Thus, interventions that take into consideration the lived experiences and broad culture for Black cisgender women are urgently needed to take a woman from medication precontemplation to uptake to maintenance.

In partnership with Black cisgender women, an established Community Advisory Council (CAC), an online telehealth platform (Q Care Plus), and beauty salon stylists, the research team co-developed Using PrEP, Doing It for Ourselves (UPDOS) Protective Styles, an e-health intervention that strongly considers the unique needs of Black cisgender women.

This intervention consists of a training for stylists to become opinion leaders (trusted gatekeepers who share health information in the community) in HIV prevention (i.e., PrEP) and a 6-week web-based, edutainment video series (i.e., six 20-minute episodes), structured debrief blogs, and telehealth service access.

The CAC was invaluable in this development process, having collaborated with the research team across sexual health-based projects that informed and contributed to UPDOS preliminary research.

UPDOS web content shares core concepts by telling the stories of women from various backgrounds and role-plays a woman's decision-making process to use PrEP.

Pilot research found UPDOS acceptable, improved PrEP trust, increased knowledge – for both PrEP aware and unaware participants, and decreased perceptions of PrEP stigma within personal relationships.

This proposed effectiveness-implementation type I hybrid study will test UPDOS effectiveness in a larger, more geographically diverse sample using a cluster-randomized controlled trial and examine implementation determinants of UPDOS.

In collaboration with Q Care Plus, a secure online platform to access telehealth services for home delivered HIV testing and PrEP prescriptions, we will track how many women reach out to a provider, get HIV testing, start PrEP, and maintain PrEP as prescribed.

A cohort of 32 beauty salons will be randomized to either an intervention group (N=16) or control group (N=16).

Salons (1 salon = 1 cluster) will be randomized to UPDOS (edutainment videos + blogs + Q Care Plus) or usual care (CDC videos + website) conditions.

Once salons are randomized, the recruitment and enrollment period of female customers will occur over 24 months.

Study participation will include data collection at baseline with follow-up measures at 1, 12, 24, 32, and 52 weeks.

To assess implementation outcomes and context, we will use a mixed methods approach guided by the Consolidated Framework for Implementation Research (CFIR).

Duke University

NURSES UNDERSTAND THAT IMPROVING HEALTH AND WELL-BEING MEANS ADDRESSING PEOPLE'S NEEDS IN MULTIPLE SETTINGS, CONTEXTS, AND OVER THE WHOLE LIFE COURSE. SCIENCE SUPPORTED BY THE NATIONAL INSTITUTE OF NURSING RESEARCH (NINR) USES THIS HOLISTIC PERSPECTIVE TO IMPROVE INDIVIDUAL AND POPULATION HEALTH AND ADVANCE HEALTH EQUITY. NINR-SUPPORTED RESEARCH PROMOTES HEALTH AND WELL-BEING BY ADDRESSING NEEDS AT MULTIPLE LEVELS INDIVIDUAL, FAMILY, COMMUNITY, AND SOCIETAL LEVELS AND DEVELOPING TREATMENT AND PREVENTION STRATEGIES THAT ARE RESPONSIVE TO THE REALITY OF PEOPLE'S LIVES. NURSES KNOW PEOPLE, AND PEOPLE TRUST NURSES. PATIENT AND FAMILIES INTERACT WITH NURSES MORE THAN ANY OTHER CLINICIANS. NURSING SCIENCE USES THIS SPECIAL RELATIONSHIP TO BETTER UNDERSTAND PATIENTS, FAMILIES, AND COMMUNITIES AND THE MANY FACTORS THAT INFLUENCE THEIR HEALTH. NURSING SCIENCE SUPPORTED BY NINR USES THIS KNOWLEDGE TO DEVELOP STRATEGIES FOR IMPROVING HEALTH AND WELLNESS ACROSS POPULATIONS, HEALTH CARE SETTINGS, AND THE LIFESPAN, WITH AN EMPHASIS ON ACHIEVING HEALTH EQUITY. NINR-SUPPORTED SCIENTISTS HAVE DEVELOPED INTERVENTIONS FOR: SUPPORTING PARENTS OF PREMATURE INFANTS, PROMOTING HIV PREVENTION IN UNDERSERVED POPULATIONS, IMPROVING TRANSITIONAL CARE LEADING TO BETTER OUTCOMES AND COST-SAVINGS, AND HELPING INNER-CITY CHILDREN MANAGE ASTHMA. NURSING SCIENCE TRANSCENDS THE BOUNDARIES OF DISEASE AND RESEARCH DISCIPLINES TO BETTER UNDERSTAND THE EXPERIENCES OF INDIVIDUALS AND FAMILIES LIVING WITH ILLNESS AND TO DEVELOP PERSONALIZED APPROACHES THAT MAXIMIZE HEALTH AND WELL-BEING FOR INDIVIDUALS AT ALL STAGES OF LIFE, ACROSS DIVERSE POPULATIONS AND SETTINGS. NINR-SUPPORTED SCIENCE USES NURSING SCIENCE'S UNIQUE, PATIENT AND COMMUNITY-FOCUSED PERSPECTIVE AND WIDE REACH ACROSS CLINICAL AND COMMUNITY SETTINGS TO ADVANCE OUR UNDERSTANDING OF THE SOCIAL DETERMINANTS OF HEALTH: THOSE FACTORS THAT ARE AT THE ROOT OF THE INEQUITIES THAT WE SEE, SUCH AS FOOD INSECURITY AND ACCESS TO HEALTHCARE. NINR RESEARCH EFFORTS IN WELLNESS INVESTIGATE THE KEY BIOLOGICAL, BEHAVIORAL, AND SOCIAL FACTORS THAT PROMOTE LONG-TERM HEALTH AND HEALTHY BEHAVIORS AND PREVENT THE DEVELOPMENT OF ILLNESS ACROSS HEALTH CONDITIONS, SETTINGS, AND THE LIFESPAN. RESEARCH IN WELLNESS IS ALSO FOCUSED ON DEVELOPING AND TESTING CULTURALLY APPROPRIATE INTERVENTIONS TO PROMOTE HEALTH AND PREVENT ILLNESS IN MINORITY AND UNDERSERVED GROUPS. NINR ALSO SUPPORTS SCIENCE TO ASSIST INDIVIDUALS, FAMILIES, AND HEALTH CARE PROFESSIONALS IN MANAGING ADVANCED, SERIOUS ILLNESS, AND PLANNING FOR END-OF-LIFE DECISIONS. IN ADDITION, NINR PROMOTES TECHNOLOGICAL ADVANCEMENTS THAT ADDRESS A RANGE OF HEALTH CARE CHALLENGES AND FACILITATE THE DELIVERY OF REAL-TIME PERSONALIZED INFORMATION TO INDIVIDUALS AND FAMILIES, HEALTH CARE PROVIDERS, AND COMMUNITIES. FINALLY, NINR HAS A LONGSTANDING AND CONTINUING COMMITMENT TO DEVELOPING THE NEXT GENERATION OF NURSE SCIENTISTS: THOSE INDIVIDUALS AND TEAM MEMBERS WHO WILL CARRY THE FIELD OF NURSING SCIENCE INTO THE FUTURE. IN ORDER TO PREPARE AN INNOVATIVE, DIVERSE, AND TALENTED NEXT GENERATION OF NURSE SCIENTISTS, NINR SUPPORTS A VARIETY OF TRAINING OPPORTUNITIES FOR SCIENTISTS AND TRAINEES AT ALL CAREER LEVELS, PARTICULARLY THOSE AT AN EARLY CAREER STAGE WHO ARE SO CRITICAL TO SUSTAINING THE FUTURE OF INNOVATIVE RESEARCH AND HIGH QUALITY HEALTH CARE.

93.361 - Nursing Research

National Institute of Nursing Research (NINR) [HHS - NIH]

Durham, North Carolina 277103038 United States

Single Zip Code

Innovations to Optimize HIV Prevention and Care Continuum Outcomes (R01 Clinical Trial Optional) (PAR-23-062)

Amendment Since initial award the total obligations have increased 382% from $803,221 to $3,870,187.