Despite an epidemic of new HIV infections in racial and ethnic minorities and continued emphasis on minority inclusion in research, minority participation in HIV/AIDS trials has not kept pace. In rural minority communities many barriers limit access to clinical trials, at the community and individual levels. This proposal seeks to fully characterize individual and community influences on research participation in rural African Americans and Latinos and develop innovative, theory based, culturally responsive interventions.
Our specific aims are:1) define community and individual factors that influence willingness of rural racial and ethnic minorities to participate in HIV/AIDS clinical trials;2) refine a theory-based, culturally responsive outreach strategy to increase enrollment in clinical trials and evaluate the acceptability of components of this outreach from the perspective of community members, providers and individuals with HIV/AIDS;and 3) determine the feasibility of the individual enrollment session and mobile unit alone and in combination to increase willingness to participate and attendance at a follow-up referral appointment and a) explore the relationship between constructs from the conceptual model (i.e., perceived barriers, perceived benefits, perceived and social resource availability) and willingness to participate in HIV/AIDS trials. In Phase 1 focus groups with community leaders, health care/service providers, and semi-structured interviews with individuals with HIV will characterize influences on willingness to participate in research. Phase 1 participants will give feedback on a culturally responsive outreach strategy: community and provider outreach, individual enrollment sessions and a mobile trials unit. In Phase 2 we will use these data to modify the conceptual model, and use the model to develop and refine the outreach strategy. Cognitive interviews with community leaders, providers and individuals with HIV will determine the acceptability each component. In Phase 3 we will conduct a single site, 12 month assessment of the individual enrollment session and mobile unit alone and in combination using a 3 arm experimental design.
