JMIR Publications

ABSTRACT

Background:

There are distinct factors that position an organization well for succeeding in implementing evidence-based practices (EBP). There are also distinct provider and organizational influences that can impede or facilitate successful integration of a new practice into providers’ daily routines. Determinant models that have come out of the child welfare and mental health fields may be particularly pertinent for the HIV field because of the similar ways in which social context influences program delivery to young people and the adoption of new practices by practitioners. To advance implementation science (IS) research related to youth HIV self-management interventions, Scale It Up (SIU) investigators are using the Exploration, Preparation, Implementation, Sustainment (EPIS) model to explore provider perceptions of EBPs used in SIU and the organizational environment in which implementation occurs.

Objective:

To describe the study protocol for ATN 153 EPIS, an effectiveness-implementation study focused on understanding barriers and facilitators of implementing enhancing HIV-related self-management interventions among youth across SIU research projects.

Methods:

SIU adopted the EPIS model across 13 subject recruitment venues participating in SIU research projects. Within each participating site, the site principal investigators (PIs) and key implementation stakeholders complete a mixed methods assessment that includes a qualitative telephone interviews and quantitative online surveys at three key implementation stages: pre-intervention implementation (Preparation), post-intervention implementation (Implementation), and during a Sustainment period. Interview and survey questions assess participants’ perceptions of EBPs, anticipated barriers and facilitators of the adoption and use of EBPs, ideas to integrate EBPs into clinic policies and procedures, and other topics related to implementing EBPs successfully in HIV care and prevention clinics.

Results:

The EPIS baseline period began in June 2017 and concluded in May 2018. To date, 153 key stakeholders and site PIs have completed qualitative interviews and 90% completed the quantitative survey. Implementation data collection will begin in March 2019.

Conclusions:

This protocol describes the model, measures, and mixed methods study design for EPIS, a study that supplements the scaling up of EBPs that can improve patient outcomes in adolescent HIV clinical settings.