Study protocol for data to suppression (D2S) : a cluster-randomised, stepped-wedge effectiveness trial of a reporting and capacity-building intervention to improve HIV viral suppression in housing and behavioural health programmes in New York City

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..

INTRODUCTION: With progress in the 'diagnose', 'link' and 'retain' stages of the HIV care continuum, viral suppression (VS) gains increasingly hinge on antiretroviral adherence among people with HIV (PWH) retained in care. The Centers for Disease Control and Prevention estimate that unsuppressed viral load among PWH in care accounts for 20% of onward transmission. HIV intervention strategies include 'data to care' (D2C)-using surveillance to identify out-of-care PWH for follow-up. However, most D2C efforts target care linkage, not antiretroviral adherence, and limit client-level data sharing to medical (versus support-service) providers. Drawing on lessons learnt in D2C and successful local pilots, we designed a 'data-to-suppression' intervention that offers HIV support-service programmes surveillance-based reports listing their virally unsuppressed clients and capacity-building assistance for quality-improvement activities. We aimed to scale and test the intervention in agencies delivering Ryan White HIV/AIDS Programme-funded behavioural health and housing services.

METHODS AND ANALYSIS: To estimate intervention effects, this study applies a cross-sectional, stepped-wedge design to the intervention's rollout to 27 agencies randomised within matched pairs to early or delayed implementation. Data from three 12-month periods (pre-implementation, partial implementation and full implementation) will be examined to assess intervention effects on timely VS (within 6 months of a report listing the client as needing follow-up for VS). Based on projected enrolment (n=1619) and a pre-implementation outcome probability of 0.40-0.45, the detectable effect size with 80% power is an OR of 2.12 (relative risk: 1.41-1.46).

ETHICS AND DISSEMINATION: This study was approved by the New York City Department of Health and Mental Hygiene's institutional review board (protocol: 21-036) with a waiver of informed consent. Findings will be disseminated via publications, conferences and meetings including provider-agency representatives.

TRIAL REGISTRATION NUMBER: NCT05140421.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:13

Enthalten in:

BMJ open - 13(2023), 7 vom: 14. Juli, Seite e076716

Sprache:

Englisch

Beteiligte Personen:

Irvine, Mary K [VerfasserIn]
Abdelqader, Faisal [VerfasserIn]
Levin, Bruce [VerfasserIn]
Thomas, Jacinthe [VerfasserIn]
Avoundjian, Tigran [VerfasserIn]
Peterson, Meghan [VerfasserIn]
Zimba, Rebecca [VerfasserIn]
Braunstein, Sarah L [VerfasserIn]
Robertson, McKaylee M [VerfasserIn]
Nash, Denis [VerfasserIn]

Links:

Volltext

Themen:

Anti-Retroviral Agents
HIV & AIDS
Health informatics
Journal Article
Patient Navigation
Public health
Quality in health care
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Anmerkungen:

Date Completed 17.07.2023

Date Revised 24.11.2023

published: Electronic

ClinicalTrials.gov: NCT05140421

Citation Status MEDLINE

doi:

10.1136/bmjopen-2023-076716

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM359524656