SPNS Initiative: Dissemination of Evidence-Informed Interventions to Improve Health Outcomes along the HIV Care Continuum Initiative, 2015-2020

Background

The Special Projects of National Significance (SPNS) Program initiative Dissemination of Evidence-Informed Interventions to Improve Health Outcomes along the HIV Care Continuum disseminates four adapted linkage and retention interventions from prior SPNS initiatives and the Secretary's Minority AIDS Initiative Fund (SMAIF) initiatives to improve health outcomes along the HIV Care Continuum. This initiative funds two cooperative agreements: a Dissemination and Evaluation Center (DEC) for five years and an Implementation Technical Assistance Center (ITAC) for four years. The end goal of the initiative is to produce four evidence-informed Care And Treatment Interventions (CATIs) that are able to be replicated, cost-effective, capable of producing optimal HIV Care Continuum outcomes, and easily adaptable to the changing health care environment.

The DEC will first adapt the four interventions and publish them on the web. The ITAC will then select and fund 12 performance sites to implement these interventions, each at three sites. The DEC will then conduct a comprehensive, multi-site evaluation of the interventions at the performance sites. The ITAC will provide implementation-related technical assistance to the sites, with the DEC providing evaluation-related technical assistance. Informed by its findings in the multi-site evaluation, the DEC will publish the four CATIs, making them ready for wider replication by Ryan White HIV/AIDS Program and other HIV care and treatment service providers. The DEC will also engage in publication and dissemination of its findings, best practices, and lessons learned.

The multi-site evaluation of this initiative will take a rigorous implementation science approach, which places greater emphasis on evaluation of the implementation process and cost analyses of the interventions, while seeking to improve the HIV Care Continuum outcomes of linkage, retention, re-engagement, and viral suppression among client participants.

Cooperative Agreement Recipients

Cooperative agreements for this initiative have been awarded to the two organizations listed below, with a brief description of their inter-related project roles.

Boston University School of Public Health, Boston, MA

Dissemination and Evaluation Center

The Center for Advancing Health Policy and Practice at the Boston University School of Public Health serves as the Dissemination and Evaluation Center (DEC) for this SPNS initiative. The DEC works with the SPNS Program and the Implementation Technical Assistance Center (ITAC) to advance replication of evidence-informed interventions from four past SPNS initiatives:

• Enhancing Linkages for Those Newly Released from Jails
• Innovative Methods for Integrating Buprenorphine Opioid Abuse Treatment in HIV Primary Care
• Targeted Outreach and Intervention Model Development for Underserved HIV-Positive Populations Not in Care
• The SMAIF Retention and Re-engagement Project

The DEC will conduct four key activities: 1) Adapt the previous evidence-informed SPNS interventions, 2) Initially disseminate the adapted interventions, 3) Conduct a rigorous multi-site evaluation of the interventions' implementation and fidelity and 4) Conduct final dissemination of the CATIs for wider replication. The DEC will also promote broad dissemination of its findings, lessons learned, and best practices through a variety of efforts, including publishing the results of the initiative in a supplemental issue of a peer-reviewed journal.

AIDS United, Washington, DC

Implementation Technical Assistance Center (ITAC)

AIDS United serves as the Implementation Technical Assistance Center (ITAC) for this SPNS initiative. The ITAC will work closely with the Dissemination and Evaluation Center (DEC) and the SPNS Program, assisting in the development of implementation-ready intervention plans for the four interventions. From those intervention plans, the ITAC will lead the development of specific TA agendas for each of the four interventions. Working with the DEC, the ITAC will identify previously-known and other possible barriers to implementation, strategies that were previously used to address those challenges and new strategies that may address those challenges. The four TA agendas will guide the ITAC's delivery of TA to the performance sites as they implement the interventions.

The ITAC will also work with the DEC and SPNS to select 12 performance sites to implement the interventions, funded by contract from the ITAC. Finally, the ITAC will lead and coordinate the logistics for national meetings of the initiative.