Yunnan-ADARC HIV Prevention Program: Developing and Testing a Model to Implement and Sustain PrEP Delivery in China
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 入组人数
- 114
- 试验地点
- 1
- 主要终点
- PrEP Awareness
研究概览
简要总结
B-HAPPY is an implementation project to study the process by which pre-exposure prophylaxis (PrEP) is introduced and integrated into a specific international health system facing high rates of HIV incidence among men who have sex with men. The study will use a stepped wedge design to compare implementation outcomes across eight municipalities in Yunnan, China.
详细描述
B-HAPPY is an implementation science project that will introduce and evaluate the implementation of PrEP among over 1000 men who have sex with men (MSM), in eight municipalities in Yunnan, China. The project aims to compare the effectiveness of two implementation strategy bundles: 1) Standard Implementation: comprising the strategies that the Yunnan Center for Disease Control and Prevention would usually use to introduce HIV prevention innovations in the absence of the proposed study; and 2) Enhanced Implementation: standard implementation enhanced by a SIC-guided approach to plan and implement PrEP.
This study will use a stepped-wedge design, where sites will go through four study periods: a Pre-Baseline Period (Routine Service with no PrEP Implementation), a Baseline Period (Standard Implementation of PrEP), an Experiment Period (Enhanced Implementation of PrEP), and a Post-Experiment-Observation Period. Sites are randomized to the timing of the intervention initiation, with 2 sites moving from Standard Implementation to Enhanced Implementation every 6 months. The intervention condition changes over time and the intervention effect is the difference in outcomes between the Baseline and Experiment Periods, and the Post-Experiment and Baseline Periods.
The specific aims of the proposed study are:
- To evaluate whether the addition of SIC-guided PrEP delivery (Enhanced Implementation) to standard health system PrEP delivery improves services outcomes. Through a stepped-wedge randomized trial across eight Yunnan municipalities, within site change over time will be examined; timing of introduction of Enhanced Implementation will be randomized across four cohorts of two sites each. Client-services outcomes include progress to achieving the "Five-80s" (patient PrEP awareness, screening, offering, initiation, continuation).
- To examine the implementation process and efficiency of the Enhanced versus Standard implementation approaches. Using the Stages of Implementation Completion (SIC) and Cost of Implementing New Strategies (COINS) tools, sites will be monitored for implementation process and resource use. Outcomes will include proportion of implementation activities completed; duration of each implementation phase; and cost and resource allocation for completion of each implementation phase.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- Male
- 接受健康志愿者
- 是
入选标准
- 未提供
排除标准
- •Clients at study sites (VCT or STI clinics) will be excluded from the study if they meet any of the following criteria:
- •Diagnosed with HIV or AIDS
- •Signs or symptoms of acute HIV infection
- •Unable to provide inform consent
- •At enrollment, has any medical, psychological, or social condition that, in the opinion of the investigator, would jeopardize the health or wellbeing of the participant during the study or the integrity of the data
- •B. Study staff:
- •Inclusion criteria:
- •Staff at study sites (VCT or STI clinics) are eligible for inclusion in the study if they meet all of the following criteria:
- •Aged 18 years or older
- •Employed at site for at least 3 months
- •Willing and able to provide consent
- •Exclusion criteria:
- •Staff at study sites (VCT or STI clinics) will be excluded from the study if they meet any of the following criteria:
- •Unable to provide consent
- •At enrollment, has any medical, psychological, or social condition that, in the opinion of the investigator, would jeopardize the health or wellbeing of the participant during the study or the integrity of the data
结局指标
主要结局
PrEP Awareness
时间窗: Up to 48 months
Number of clients who are aware of PrEP
PrEP Eligible
时间窗: Up to 48 months
Number of clients who are eligible for PrEP
PrEP Offer
时间窗: Up to 48 months
Number of clients who are offered PrEP
PrEP Initiation
时间窗: Up to 48 months
Number of clients initiating PrEP
PrEP Continuation
时间窗: Up to 48 months
Number of PrEP initiators who remain PrEP-eligible and sustain use at six months
Proportion of PrEP Implementation Activities Completed
时间窗: Up to 48 months
The SIC is an 8-stage observational assessment tool recording organizational site completion of implementation activities that map onto the three phases of implementation (Pre-Implementation, Implementation, Sustainability). Proportion of PrEP implementation activities completed will be measured.
Time to Completion for Each Implementation Phase
时间窗: Up to 48 months
The SIC is an 8-stage observational assessment tool recording organizational site completion of implementation activities that map onto the three phases of implementation (Pre-Implementation, Implementation, Sustainability). Time to completion of each implementation phase will be measured.
Cost and Resource Allocation for Completion of Each Implementation Phase
时间窗: Up to 48 months
Costs and resource allocation for completion of each implementation phase will be measured with the Cost of Implementing New Strategies (COINS) tool.
次要结局
未报告次要终点
研究者
Kathrine Meyers
Assistant Professor of Medicine
Columbia University