Randolph Schenita D, Johnson Ragan, Johnson Allison, Keusch Lana
Duke University School of Nursing, Duke University, Durham, NC, United States.
JMIR Res Protoc. 2022 Aug 30;11(8):e34556. doi: 10.2196/34556.
Multilevel interventions are necessary to address the complex social contributors to health that limit pre-exposure prophylaxis use among Black women, including medical distrust, pre-exposure prophylaxis stigma, and access to equitable health care. Strategies to improve knowledge, awareness, and uptake of pre-exposure prophylaxis among Black women will be more successful if information-sharing and implementation take place within trusted environments. Providing women with information through trusted cultural and social channels can effectively support informed decision-making about pre-exposure prophylaxis for themselves and members of their social networks who are eligible for pre-exposure prophylaxis.
The goal of this project is to improve knowledge, awareness, uptake, and trust of pre-exposure prophylaxis, as well as reduce pre-exposure prophylaxis stigma, among Black women living in the US South.
This multilevel, mixed methods study uses a community-engagement approach to develop and pilot test a salon-based intervention. There are three components of this intervention: (1) stylist training, (2) women-focused entertainment videos and modules, and (3) engagement of a pre-exposure prophylaxis navigator. First, stylist training will be provided through two 2-hour training sessions delivered over 2 consecutive weeks. We will use a pre- and posttest design to examine knowledge and awareness improvement of pre-exposure prophylaxis among the stylists. Upon full completion of training, the stylists will receive a certificate of completion and "Ask Me about PrEP" signage for their beauty salons. Second, together with the community, we have codeveloped a 4-part entertainment series (The Wright Place) that uses culturally and socially relevant stories to highlight key messages about (1) HIV, (2) pre-exposure prophylaxis, and (3) Black women's social contributors to health. Quantitative and qualitative measures will be used in a pre- and posttest design to examine pre-exposure prophylaxis knowledge, awareness, risk, stigma, trust, intentions, and women's perceptions of the usability and acceptability of the overall intervention and its implementation strategies. A video blog will be provided after each video. Third, participants will have access through an email or text message link to a pre-exposure prophylaxis navigator, who will respond to them privately to answer questions or make referrals for pre-exposure prophylaxis as requested.
This project was funded in October 2020 by Gilead Sciences and was approved by the Duke University School of Nursing institutional review board in April 2021 (Pro00106307). Intervention components were developed in partnership with community partners in the first year. Data collection for phase 1 began in April 2022. Data collection for phase 2 began in May 2022. The study will be complete by October 2022.
Multilevel interventions that consider the assets of the community have promise for promoting health among Black women who have influence within their social networks. The findings of this study have the potential to be generalizable to other populations.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/34556.
多层次干预对于解决影响健康的复杂社会因素至关重要,这些因素限制了黑人女性使用暴露前预防药物,包括医疗不信任、暴露前预防药物污名化以及获得公平医疗保健的机会。如果在可信赖的环境中进行信息共享和实施,提高黑人女性对暴露前预防药物的知识、意识和接受度的策略将更有可能成功。通过可信赖的文化和社会渠道为女性提供信息,可以有效地支持她们就自身以及符合暴露前预防药物使用条件的社交网络成员的暴露前预防药物使用做出明智的决策。
本项目的目标是提高美国南部黑人女性对暴露前预防药物的知识、意识、接受度和信任度,并减少暴露前预防药物的污名化。
这项多层次、混合方法的研究采用社区参与方法来开发并试点测试一种基于沙龙的干预措施。该干预措施有三个组成部分:(1)发型师培训,(2)以女性为中心的娱乐视频和模块,(3)配备暴露前预防药物导航员。首先,将通过连续两周进行的两次2小时培训课程提供发型师培训。我们将采用前后测试设计来检验发型师对暴露前预防药物知识和意识的提高情况。培训全部完成后,发型师将获得结业证书以及用于其美容院的“向我询问暴露前预防药物”标识牌。其次,我们与社区共同开发了一个4部分的娱乐系列节目(《正确的地方》),该节目利用与文化和社会相关的故事来突出关于(1)艾滋病毒、(2)暴露前预防药物以及(3)黑人女性对健康的社会影响因素的关键信息。将在前后测试设计中使用定量和定性措施来检验暴露前预防药物的知识、意识、风险、污名化、信任、意愿,以及女性对整个干预措施及其实施策略的可用性和可接受性的看法。每个视频之后将提供一个视频博客。第三,参与者可以通过电子邮件或短信链接联系暴露前预防药物导航员,导航员将私下回复他们,根据要求回答问题或为暴露前预防药物进行转介。
本项目于2020年10月获得吉利德科学公司的资助,并于2021年4月获得杜克大学护理学院机构审查委员会的批准(Pro00106307)。干预措施的各个组成部分在第一年与社区合作伙伴合作开发。第一阶段的数据收集于2022年4月开始。第二阶段的数据收集于2022年5月开始。该研究将于2022年10月完成。
考虑到社区资源的多层次干预措施有望促进在其社交网络中有影响力的黑人女性的健康。本研究的结果有可能推广到其他人群。
国际注册报告识别码(IRRID):PRR1-10.2196/34556。