Leveraging a Strategic Alliance to Characterize, Protocolize, and Scale Up Local Implementation Strategies for Improving PrEP and Mental Health/Substance Use Treatment Reach

In response to NOT-AI-23-070, we propose to characterize, assess, and protocolize implementation strategies that HIV organizations are using to improve the reach of PrEP and mental health/substance use treatments to Hispanic men, and then build a platform to scale up these strategies to other United States jurisdictions. Current reach of these services does not meet community needs, fueling the ongoing transmission of HIV; thus, contextually relevant implementation strategies are urgently needed. In an innovative yet underused approach that contrasts with traditional implementation research, successful implementation strategies already used by HIV organizations will be scaled up and disseminated through a “ground up” approach. Our team formed a strategic alliance of community-based implementers and researchers in three regions where HIV incidence is particularly high. To improve reach of PrEP and mental health/substance use treatments, implementers from our strategic alliance use implementation strategies that they consider to be successful, feasible, and relevant for their communities and organizations. These strategies may be more feasible and contextually relevant than those produced in traditional research-to-practice approaches. We propose to leverage the infrastructure and trusted collaborations inherent in our strategic alliance to rigorously characterize and identify strategies these organizations use that align with the evidence base for implementation determinants and behavior change methods, using innovative implementation science methods, including Rapid Assessment Procedure Informed Clinical Ethnography and reverse implementation mapping. We will protocolize strategies that meet our inclusion criteria and build an online Implementation Strategy Dashboard, following user-centered design, which we will evaluate for usability and impact. Specific aims are 1. To characterize, assess, and protocolize the implementation strategies currently used by organizations in our strategic alliance to improve PrEP and mental health/substance use treatment reach. 2. To build a Dashboard of strategies that meet Aim 1 inclusion criteria for improving the reach of PrEP and mental health/substance use treatment. 3. To assess the Dashboard’s usability and associated organizational outcomes in HIV organizations across the United States. Completion of these aims will address the suboptimal reach of PrEP and mental health/substance use treatments by drawing primarily on implementer expertise. Our innovative approach of scaling up implementation strategies from existing local practices in regions where HIV incidence is high disrupts traditional research-to-practice pathways and is likely to have a powerful and sustained public health impact. Our findings will impact the field by 1) identifying contextually appropriate and feasible implementation strategies and 2) developing and evaluating a dashboard for scaling up the strategies in pursuit of ending HIV across the United States.