دورية أكاديمية
A hybrid design testing a 3-step implementation model for community scale-up of an HIV prevention intervention in rural Malawi: study protocol.
العنوان: | A hybrid design testing a 3-step implementation model for community scale-up of an HIV prevention intervention in rural Malawi: study protocol. |
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المؤلفون: | Jere DLN; Community and Mental Health Nursing, Kamuzu College of Nursing, University of Malawi, P.O Box, 415, Blantyre, Malawi. dijere@kcn.unima.mw., Banda CK; Medical-Surgical Nursing, Kamuzu College of Nursing, University of Malawi, P.O Box, 415, Blantyre, Malawi., Kumbani LC; Faculty of Midwifery, Neonatal and Reproductive Health, Kamuzu College of Nursing, University of Malawi, P.O Box, 415, Blantyre, Malawi., Liu L; Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, USA., McCreary LL; Health Systems Science, College of Nursing, University of Illinois at Chicago, 845 South Damen Ave, Chicago, IL, 60612, USA., Park CG; Health Systems Science, College of Nursing, University of Illinois at Chicago, 845 South Damen Ave, Chicago, IL, 60612, USA., Patil CL; Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, 845 South Damen Ave, Chicago, IL, 60612, USA., Norr KF; Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago, 845 South Damen Ave, Chicago, IL, 60612, USA. |
المصدر: | BMC public health [BMC Public Health] 2018 Aug 02; Vol. 18 (1), pp. 950. Date of Electronic Publication: 2018 Aug 02. |
نوع المنشور: | Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural |
اللغة: | English |
بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: London : BioMed Central, [2001- |
مواضيع طبية MeSH: | Rural Population*, HIV Infections/*prevention & control , Health Education/*organization & administration , Safe Sex/*statistics & numerical data, Acquired Immunodeficiency Syndrome/prevention & control ; Adolescent ; Adult ; Community Health Workers/education ; Female ; Humans ; Inservice Training/organization & administration ; Malawi/epidemiology ; Male ; Peer Group ; Program Development ; Program Evaluation ; Reproducibility of Results ; Research Design ; Social Behavior ; Young Adult |
مستخلص: | Background: Scaling-up evidence-based behavior change interventions can make a major contribution to meeting the UNAIDS goal of no new HIV infections by 2030. We developed an evidence-based peer group intervention for HIV prevention and testing in Malawi that is ready for wider dissemination. Our innovative approach turns over ownership of implementation to rural communities. We adapted a 3-Step Implementation Model (prepare, roll-out and sustain) for communities to use. Using a hybrid design, we simultaneously evaluate community implementation processes and program effectiveness. Methods: Three communities in southern Malawi begin implementation in randomly-assigned order using a stepped wedge design. Our evaluation sample size of 144 adults and 144 youth per community provides sufficient power to examine primary outcomes of condom use and HIV testing. Prior to any implementation, the first participants in all three communities are recruited and complete the Wave 1 baseline survey. Waves 2-4 surveys occur after each community completes roll-out. Each community follows the model's three steps. During Prepare, the community develops a plan and trains peer group leaders. During Roll-Out, peer leaders offer the program. During Sustain, the community makes and carries out plans to continue and expand the program and ultimately obtain local funding. We evaluate degree of implementation success (Aim 1) using the community's benchmark scores (e.g, # of peer groups held). We assess implementation process and factors related to success (Aim 2) using repeated interviews and observations, benchmarks from Aim 1 and fidelity assessments. We assess effectiveness of the peer group intervention when delivered by communities (Aim 3) using multi-level regression models to analyze data from repeated surveys. Finally, we use mixed methods analyses of all data to assess feasibility, acceptability and sustainability (Aim 4). Discussion: The project is underway, and thus far the first communities have enthusiastically begun implementation. We have had to make several modifications along the way, such as moving from rapid-tests of STIs to symptoms screening by a nurse due to problems with test reliability and availability. If successful, results will provide a replicable evidence-based model for future community implementation of this and other health interventions. Trial Registration: Clinical Trials.gov NCT02765659 Registered May 6, 2016. |
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معلومات مُعتمدة: | R01 NR015409 United States NR NINR NIH HHS |
فهرسة مساهمة: | Keywords: Adolescent; Adult; Community implementation; Community participation; HIV prevention; Implementation science; Malawi; Peer group intervention |
سلسلة جزيئية: | ClinicalTrials.gov NCT02765659 |
تواريخ الأحداث: | Date Created: 20180804 Date Completed: 20190916 Latest Revision: 20240329 |
رمز التحديث: | 20240329 |
مُعرف محوري في PubMed: | PMC6090759 |
DOI: | 10.1186/s12889-018-5800-3 |
PMID: | 30071866 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1471-2458 |
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DOI: | 10.1186/s12889-018-5800-3 |