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Increasing pre-exposure prophylaxis (PrEP) in primary care: A study protocol for a multi-level intervention using the

Elizabeth Lockhart1, DeAnne Turner2, Kate Guastaferro3

  • 1Center for Health Policy and Health Services Research, Henry Ford Health, 1 Ford Pl., Detroit, MI 48202, USA.

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Summary
This summary is machine-generated.

This study used the Multiphase Optimization Strategy (MOST) to develop a multilevel intervention to increase pre-exposure prophylaxis (PrEP) prescriptions by primary care providers. The goal is to improve HIV prevention for priority populations.

Keywords:
Computer-based simulationHIVImplementation scienceMultilevelMultiphase optimization strategyPrEPPrimary care

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Area of Science:

  • Public Health
  • HIV Prevention Research
  • Intervention Science

Background:

  • Over 1.2 million people in the US live with HIV, disproportionately affecting key populations.
  • Pre-exposure prophylaxis (PrEP) is a highly effective HIV prevention tool.
  • Barriers hinder both PrEP prescription by primary care providers (PCPs) and patient initiation.

Purpose of the Study:

  • To identify and optimize a multi-level intervention to increase PrEP uptake in primary care settings.
  • To address barriers faced by both PCPs and patients regarding PrEP.
  • To focus on priority populations for PrEP initiation.

Main Methods:

  • Utilized the Multiphase Optimization Strategy (MOST) framework.
  • Incorporated patient and provider feedback to tailor intervention components.
  • Employed a 2^4 factorial design experiment to test intervention components.
  • Included provider training, best practice alerts, educational videos, and risk assessments.
  • Qualitatively examined facilitators and barriers to implementation.

Main Results:

  • This protocol outlines a novel multilevel MOST optimization trial in healthcare.
  • Intervention components target both providers and patients within a large healthcare system.
  • The study is situated in an HIV Ending the Epidemic priority jurisdiction.

Conclusions:

  • This multilevel intervention aims to significantly impact HIV prevention.
  • Successful implementation could lead to wider dissemination in healthcare systems.
  • This represents one of the first multilevel MOST trials in a healthcare context.