Not provided
Not provided
Not provided
| ID | Type | Description | Link |
|---|---|---|---|
| R01NR021528-01 | U.S. NIH Grant/Contract | View source |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Class |
|---|---|
| National Institute of Nursing Research (NINR) | NIH |
Not provided
Not provided
Not provided
Not provided
Women living with HIV/AIDS (WLWHA) in Baltimore experience disproportionately high rates of intimate partner violence (IPV), housing instability, and food insecurity, which adversely affect health outcomes. The Bartlett Bridges study is being implemented in partnership with the John G. Bartlett Infectious Diseases Specialty Practice (Bartlett Clinic) located at Johns Hopkins Hospital. The Bartlett Clinic provides comprehensive, compassionate and equitable services for infectious disease prevention, diagnosis and care. The study team will adapt and evaluate a trauma and violence-informed care (TVIC) intervention, called Confidentiality, Universal Education and Empowerment and Support (CUES), enhanced with the evidence-based myPlan safety planning app in the Bartlett Clinic to address IPV, health and safety in partnership with community organizations that provide advocacy, housing and social services. This hybrid effectiveness-implementation trial aims to improve HIV and mental health outcomes, increase safety, reduce health disparities, and identify implementation mechanisms to inform future scale-up and sustainability of the intervention in healthcare settings.
Objectives Aim 1: Using the ADAPT-ITT framework, the clinic-community partners will collaboratively adapt/design the CUES intervention enhanced with myPlan and connections to community organizations (CUES+) to meet the complex health and safety needs of abused WLWHA. The Hopkins team and members of the investigator's clinic-community advisory board (CAB) will collaborate to adapt and design the CUES+ intervention.
Aim 2: Examine the effectiveness of the CUES+ intervention in reducing health disparities for abused WLWHA. All WLWHA clients will receive CUES+ through the clinic-community partnership. Primary outcomes (ART adherence, missed visits/proportion of visits missed, treatment adherence self-efficacy) and mental health (depression, PTSD) will be measured at baseline, 6-, and 12-months post baseline. The investigators hypothesize IPV(+) WLWHA will have poorer outcomes than IPV(-) WLWHA at baseline. After the CUES+ intervention, outcomes for IPV(+) WLWHA will approach the level of outcomes for IPV(-) WLWHA.
Aim 3: Assess the mechanisms, facilitators, and barriers to implementation of clinic-community CUES+ intervention. Aim 3a: Mechanisms (e.g., safety behaviors/resources, IPV exposure, housing stability, food security) by which CUES+ intervention improves primary outcomes will be examined. The investigators hypothesize the intervention will increase safety behaviors and resources, housing stability and food security and reduce IPV exposure resulting in improvements in primary health outcomes. An understanding of mechanisms will identify clinic-community organizational culture, resources and policies needed to sustain the partnership. Aim 3b: Examine clinic-community-based partners contextual and program factors that facilitate the intervention and are needed to sustain the partnerships. The investigators will also examine barriers and facilitators to the intervention from the perspectives of clinicians and community-based partners to inform future implementation and scale-up.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Women with HIV/AIDS and IPV | Adult women receiving care at Hopkins Bartlett Clinic diagnosed with HIV/AIDS and report past year intimate partner violence (IPV) | ||
| Women with HIV/AIDS, no IPV | Adult women receiving care at Hopkins Bartlett Clinic diagnosed with HIV/AIDS, no past year IPV |
Not provided
| Measure | Description | Time Frame |
|---|---|---|
| Depression as assessed by the PROMIS Depression scale | PROMIS Depression 8. Score range 0 to 32; higher score is worse | Baseline, 6 and 12 months post baseline |
| HIV-related viral load | Obtained from Medical Record. Score range 0->100,000; higher scores are worse | 12 months post baseline |
| PTSD Checklist (PCL-6) | PCL-6 - 6 items. Score range: 0-24; higher score is worse | Baseline, 6 and 12 months post-baseline |
| Retrospective HIV adherence | Retrospective Adherence 5-items. Score range 0-15; higher score is worse | Baseline, 6 and 12 months post-baseline |
| HIV Adherence Self-Efficacy | HIV Adherence Self-Efficacy Scale 13-items. Score range 0-39; higher score is better | Baseline, 6 and 12 months post-baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Safety Behaviors survey | Safety Behaviors survey adapted from previous studies. 28 items, Score range 0-28; higher is better. | Baseline, 6 and 12 months post-baseline |
| Intimate partner violence (IPV) as assessed by the Composite Abuse Scale |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Adult female identified patients at Hopkins Bartlett Clinic with diagnosis of HIV/AIDS
Not provided
| Name | Affiliation | Role |
|---|---|---|
| Nancy Glass | Johns Hopkins School of Nursing | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Johns Hopkins Bartlett Clinic | Baltimore | Maryland | 21205 | United States |
Not provided
| ID | Term |
|---|---|
| D000163 | Acquired Immunodeficiency Syndrome |
| ID | Term |
|---|---|
| D015658 | HIV Infections |
| D000086982 | Blood-Borne Infections |
| D003141 | Communicable Diseases |
| D007239 | Infections |
Not provided
Not provided
Not provided
Not provided
Not provided
Composite Abuse Scale (CASr-SF). 15 items, Score range 0-75; higher is worse
| Baseline, 6 and 12 months post-baseline |
| Housing Stability as assessed by the Homelessness Screening Clinical Reminder | Homelessness Screening Clinical Reminder (HSCR). 10 items, Score range 0-10; higher score is worse | Baseline, 6 and 12 months post-baseline |
| Food security as assessed by the Food Security in the US Survey | USDA measure. 8 items. score range: 0 to 16; higher score is worse | Baseline, 6 and 12 months post-baseline |
| Housing Conditions as assessed by the Property Condition Assessment | HUD definitions, Property Condition Assessment. 2 items, score range 0 to 8; higher score is worse | Baseline, 6 and 12 months post-baseline |
| Suicide Behavior | Ideation and attempts. 2 items, score range 0-2; higher score is worse | Baseline, 6 and 12 months post-baseline |
| Health and Well-being as assessed by the PROMIS Global Health Scale | PROMIS Global Health Scale. 10 items, score range 4-20; higher score is better | Baseline, 6 and 12 months post baseline |
| D015229 |
| Sexually Transmitted Diseases, Viral |
| D012749 | Sexually Transmitted Diseases |
| D016180 | Lentivirus Infections |
| D012192 | Retroviridae Infections |
| D012327 | RNA Virus Infections |
| D014777 | Virus Diseases |
| D012897 | Slow Virus Diseases |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D007153 | Immunologic Deficiency Syndromes |
| D007154 | Immune System Diseases |