(30 lines of text) 2 Technological advances and high-level policy commitments to eliminate HIV in the U.S. 3 within a decade offer a unique opportunity to make major progress towards patient- 4 centered adherence support. To realize this opportunity and minimize possible 5 downsides, an interdisciplinary approach is needed to elicit and integrate attitudes of 6 patients and other stakeholders towards different support options. 7 The parent R01 tests the effectiveness of peer-support in promoting ART 8 adherence in low-income African-American and Latina women living with HIV (WLH) in 9 the last trimester of pregnancy and postpartum. Study outcomes (retention in HIV care 10 and viral suppression) are measured one year postpartum. In an interdisciplinary 11 approach bridging clinical science, anthropology, ethics and behavioral economics, we 12 broaden the scope in this supplement by applying the Consolidated Framework for 13 Implementation Research (CFIR). Though qualitative interviews, we seek to understand 14 how peer-support participants, and key providers (physicians, case managers, and 15 payers), relate to peer-support, to more fully understand possible conduits, barriers and 16 synergies in implementing adherence support approaches in a patient-centered way 17 (Specific Aim 1), In addition, we interview women declining peer-support, to better 18 understand their reasons, and to elicit preferences towards alternative adherence 19 support options, such as electronic pill bottles that send signals when medications are 20 removed from containers; automated or in-person video conferencing, or pills with 21 embedded sensors (Specific Aim 2). The limitations of the 12-month study period will 22 not enable us to query the peer-support group about their attitudes towards such 23 alternatives, but we will capture the views of the provider groups (physicians, case 24 managers, and payers), currently absent from the literature. 25 In alignment with goals 1 and 2 of the trans-NIH strategic plan for Women's 26 Health Research, this extended process evaluation study addresses the needs of 27 understudied, underrepresented, and underreported populations. The study 28 considerably strengthens external validity and scalability of the parent R01 and, 29 independently, adds to the knowledge of how to implement adherence support in a 30 patient-centered way.
Toward patient-centered medication adherence support for pregnant and postpartum women living with HIV in the age of digital health and Artificial Intelligence Project Narrative (Three sentences) The parent R01 tests the effectiveness of peer-support in promoting adherence to ART in African-American and Latina women living with HIV in the last trimester of pregnancy and postpartum. In an interdisciplinary approach that bridges clinical science, anthropology, ethics and behavioral economics, we broaden the scope in this supplement by applying the Consolidated Framework for Implementation Research to better understand through qualitative interviews how peer-support participants, and key providers, experience the peer-support intervention. In addition, we interview women declining the peer-support intervention to better understand their reasons, and to elicit preferences towards alternative options of adherence support: the overall approach considerably strengthens external validity and scalability of the parent R01 and, independently, adds to the knowledge of how to implement adherence support in a patient-centered way.
