The primary training objectives of the proposed K23 Mentored Patient-Oriented Research Development Award is to develop expertise in advanced quantitative methods and multilevel data analysis, implementation science and social network methodologies. This will build on my existing training in qualitative methods, community based approaches, and African American church based research on development of interventions to prevent HIV. My long-term objective is to become an independent investigator and to use the proposed study to support a R01. I will have the support of an interdisciplinary team of experts in my proposed areas of training including Drs. Carl Latkin, David Celentano, Patricia Davidson, and Loretta Sweet Jemmott. The research portion of this application aims to test the effect of the addition of a peer education network intervention, Self Help in Eliminating Life-Threatening Disease (SHIELD)75 as an implementation strategy to promote acceptability and maintenance of Sister to Sister an evidence based HIV risk reduction intervention for African American women between the ages of 18-44 in church settings and to examine the role of organizational variables on implementation. The study is framed by an integrated version of the Diffusion of Innovations Model (DIM)76 and the Practical, Robust, Implementation and Sustainability Model (PRISM)25, which looks at implementation and maintenance from a multi-level approach.
For Aim 1 we will use a hybrid type 2 effectiveness-implementation design and test the effect of the addition of SHIELD on the behavioral outcomes of consistent condom use and number of unprotected sexual intercourse acts, and the implementation outcomes of acceptability and maintenance of the intervention.
In Aim 2 we will used a mixed methods convergent parallel design57 to examine the organizational factors contributing to implementation. The importance of this study cannot be understated. Disproportionately high rates of HIV continue to persist among African American women. Despite the availability of several evidence-based interventions to reduce rates of HIV, there is a significant gap in scientific knowledge on how to implement these interventions effectively into influential community settings for long-term use. With additional training, I will be able to bridge this gap. The public health significance of the proposed researc is crucial, as finding ways to successfully implement and sustain interventions can make a substantial impact on prevention of HIV. This study also supports the National HIV/AIDS Strategy (NHAS) 73 to engage the faith community in HIV risk reduction and supports NIMH's goals to identify ways to distribute health services across service sectors that will produce the greatest synergy and best outcomes.74This study's innovation lies in its aim to expand HIV prevention efforts through the engagement of nontraditional sites for implementation of evidence based HIV risk reduction interventions for African Americans.
Implementation of evidence base interventions for HIV into community settings is an issue of great public health relevance for the Black American population. Innovative, community based approaches that use significant institutions, such as the Black Church, are instrumental in this endeavor. This research proposes an innovative network approach to engaging underutilized Black Churches in promotion of implementation of evidence based HIV risk reduction interventions.
| Stewart, Jennifer M; Hong, Hyejeong; Powell, Terrinieka W (2018) African American Church Engagement in the HIV Care Continuum. J Assoc Nurses AIDS Care 29:406-416 |
| Davey-Rothwell, Melissa A; Stewart, Jennifer; Vadnais, Alison et al. (2017) The Role of Partner Support Among Women with Depressive Symptoms. Community Ment Health J 53:415-419 |
| Stewart, Jennifer M; Hanlon, Alexandra; Brawner, Bridgette M (2017) Predictors of HIV/AIDS Programming in African American Churches: Implications for HIV Prevention, Testing, and Care. Health Educ Behav 44:385-393 |
| Stewart, Jennifer M; Thompson, Keitra (2016) Readiness to Implement HIV Testing in African-American Church Settings. J Relig Health 55:631-40 |
| Stewart, Jennifer M; Rogers, Christopher K; Bellinger, Dawn et al. (2016) A Contextualized Approach to Faith-Based HIV Risk Reduction for African American Women. West J Nurs Res 38:819-36 |
