There is continuing need for improved strategies to prevent the spread of HIV, particularly among men who have sex with men (MSM). Over half of those living with HIV in the US are MSM and MSM continue to account for two-thirds of new HIV infections. Personalized Cognitive Counseling (PCC) is a brief, effective HIV risk reduction intervention for MSM. PCC has been designated by the Centers for Disease Control and Prevention (CDC) as a ?Best-Evidence Intervention,? and the CDC actively disseminates PCC using training materials developed by the applicant company (Allen/Loeb Associates) and the developer of PCC (Dr. James Dilley). Empirical data show that training is not sufficient for implementation of evidence-based HIV prevention interventions in real-world settings. Post-training support is essential, yet no affordable support strategies are available. To meet this need, the developers of the PCC intervention and training developed and tested two strategies for scalable, low-cost, web-based post-training support with Phase I SBIR funding from NIMH (?Web-Based Support For Implementation of Evidence-Based HIV Prevention (PCC),? R43MH099917). Phase I usability tests showed that both strategies--person-to-person consultation (P2P) and video support--are highly acceptable to counselors and are associated with increases in counselor self-efficacy related to PCC delivery. This Phase II project builds on Phase I findings to rigorously test web-based post-training support for PCC. Seventy-five counselors who have recently completed PCC training will be randomized to one of three levels of increasingly intensive post-training support: (1) Information, (2) Video Support & Information, and (3) P2P & Video Support and Information. The impact of post-training support on PCC self-efficacy, knowledge, and implementation will be assessed at study entry, 6 weeks after study entry and 3 months later. We hypothesize that (1) the impact of Video Support & Information will be greater than the impact of Information alone and (2) the impact of P2P & Video Support & Information will be greater than both other conditions. Results of these hypothesis tests will inform the optimal configuration of post-training support for commercialization. The Phase II study will yield a fully functional, market-ready support platform. The primary target market for the platform is Capacity Building Assistance (CBA) providers that are funded by the CDC to provide technical assistance to the CBOs, health departments, and hospitals that deliver evidence-based HIV prevention interventions. Throughout the study period, existing relationships with the CDC and CBA providers will be further developed to insure that the post-training support platform meets customer needs. The web-based support strategies developed for PCC can be generalized to other evidence-based prevention interventions.
Mounting evidence shows that provider training alone does not result in broad implementation of much needed evidence-based HIV prevention interventions. Post-training support is needed, but no affordable strategies are currently available. This Phase II SBIR project will rigorously evaluate web-based post-training support strategies previously developed with Phase I funding in a randomized trial; the proposed project will yield a market-ready, scalable, web-based post-training support platform for counselors delivering Personalized Cognitive Counseling, a brief, effective HIV prevention intervention for men who have sex with men that has considerable potential for widespread implementation.
