Increasing pre-exposure prophylaxis (PrEP) in primary care: A study protocol for a multi-level intervention using the multiphase optimization strategy (MOST) framework
Recommended Citation
Lockhart E, Turner D, Guastaferro K, Szalacha LA, Alzate HT, Marhefka S, Pittiglio B, Dekker M, Yeh HH, Zelenak L, Toney J, Manogue S, and Ahmedani BK. Increasing pre-exposure prophylaxis (PrEP) in primary care: A study protocol for a multi-level intervention using the multiphase optimization strategy (MOST) framework. Contemp Clin Trials 2024; 143:107599.
Document Type
Article
Publication Date
8-1-2024
Publication Title
Contemp Clin Trials
Abstract
BACKGROUND: In the United States, over 1.2 million people are living with HIV. This disease disproportionately affects men who have sex with men (MSM), people of color, youth and young adults, and transgender individuals. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention method. Barriers exist for both primary care providers (PCPs) to prescribe PrEP and prevent patients from initiating PrEP.
METHODS: This study, MOST: PrEP, follows the multiphase optimization strategy (MOST) framework. The purpose is to identify a multi-level intervention among patients and PCPs to increase PrEP prescriptions in primary care. First, feedback will be obtained from providers and patients via focus groups, then, suggestions related to the context-specific (provider and individual level) factors of intervention component delivery will be incorporated. Subsequently, a rigorous experiment will be conducted using a 2(4) factorial design focusing on priority populations for PrEP initiation. Provider components include computer-based simulation training and a best practice alert. Patient components include a tailored PrEP educational video and HIV risk assessment. Finally, the facilitators and barriers to implementing the intervention components will be qualitatively examined.
CONCLUSION: In this protocol paper, we describe the one of the first known multilevel MOST optimization trial in healthcare. Intervention components are to be delivered to patients and providers in a large healthcare system, based in an HIV Ending the Epidemic priority jurisdiction. If effective, this multi-level approach could be disseminated to providers and patients in other large healthcare systems to make a significant impact on HIV prevention.
Medical Subject Headings
Humans; Pre-Exposure Prophylaxis; HIV Infections; Primary Health Care; Male; Anti-HIV Agents; Homosexuality, Male; Female; Adult; United States; Young Adult; Focus Groups; Practice Patterns, Physicians'
PubMed ID
38848935
Volume
143
First Page
107599
Last Page
107599
