loading
loading
NIH grant 1R03NR022624-01: From Evidence to Practice for Health Provider Implementation of HIV PrEP in the United States
Institute: {'code': 'NR', 'abbreviation': 'NINR', 'name': 'National Institute of Nursing Research', 'admin_org_id': '12500052', 'admin_funding_url': ''}. PI: Kevin Anthony Fiscella. Award: $151063.
Start: 2026-09-25T00:00:00.
Project Abstract: This R03 will generate actionable, implementation science–ready evidence to optimize delivery
of HIV pre-exposure prophylaxis (PrEP) by healthcare providers in the U.S. Despite PrEP’s high preventive efficacy
when taken as prescribed, uptake and sustained use remain suboptimal, with persistent breakdowns across the
PrEP implementation continuum (i.e., risk identification and linkage to prescribing/initiation, billing/reimbursement
workflows, and long-term retention/adherence support). Providers are the key agents of implementation at every
stage. Yet, the evidence base is rapidly growing, methodologically heterogeneous, and fragmented across care
settings (e.g., primary care, women’s health, emergency departments, HIV clinics, pharmacies) and service-delivery
routes (e.g., PrEP navigators, tele-PrEP, same-day initiation, pharmacy- and EHR-enabled models, buy-and-bill
workflows). Consequently, health systems lack an integrated, empirically grounded resource to select, adapt, and
scale PrEP implementation strategies for specific contexts and populations. Building on our prior synthesis, we will
conduct a PRISMA-guided systematic review and Bayesian meta-implementation study explicitly grounded in
implementation science concepts (implementation stages, strategies/routes, contextual determinants, and
implementation outcomes). Aim 1 will use Bayesian hierarchical meta-analysis and meta-regression to: (1a) quantify
provider engagement across sequential implementation stages (e.g., provider PrEP awareness, HIV risk
identification, counseling, billing practices, prescribing/initiation, and follow-up for retention/adherence), and (1b)
compare real-world implementation routes/strategies in relation to key implementation outcomes (linkage, initiation,
retention), while modeling heterogeneity by provider type, clinical setting, geographic region, training, and
policy/time period. Aim 2 will integrate Bayesian outputs with a structured thematic synthesis and expert-panel input
to produce a concise, menu-driven Operational Manual that maps strategies to continuum stages, specifies core
components and contextual prerequisites, and includes “Evidence-to-Action” tables translating posterior
probabilities into plain-language guidance for implementation decisions. Over two years, this project will deliver (1)
a rigorously curated dataset of provider-focused PrEP implementation evidence, (2) a transparent and reproducible
Bayesian meta-implementation analytic framework and codebook, and (3) a practice-oriented Operational Manual
to directly inform subsequent pilot testing and accelerate progress toward Ending the HIV Epidemic through
evidence-informed PrEP implementation.document fetched 2026-10-04 02:43