PrEP Blueprint: Evaluating implementation of a PrEP Choice Blueprint on PrEP Uptake and Persistence - PROJECT SUMMARY/ABSTRACT PrEP Blueprint is a project designed to create a blueprint to assist clinics currently offering PrEP in scaling up these efforts and offering all types of PrEP options to persons who may benefit from PrEP. The study will take place in two phases. In the first phase (Aim 1, year 1), we will assemble and adapt the PrEP Blueprint with client, clinic staff, and community stakeholder input. We will do this through Human Centered Design (HCD) with client and clinic staff in San Francisco, California and Birmingham, Alabama to identify implementation barriers in scaling up PrEP and which strategies would be desired, feasible, and client-centered to best address the needs of potential or current PrEP users. We will conduct three half-day workshops with 10 clients, and 20 staff at each of two clinics, a community sexual health clinic in San Francisco, and a university infectious disease clinic in Birmingham. The goal of these HCD workshops is to brainstorm new ideas (Ideation Workshop) to improve PrEP implementation within the clinical context; develop potential strategies (Prototyping Workshop) to address the implementation challenges; and review the prototypes identify the solutions which are most acceptable, feasible, and efficient (Testing Workshop) prior to implementation. Through these HCD activities we will determine what is feasible for each of the clinics to implement, and what client-facing (e.g., PrEP decision support tool to help people select the type of PrEP that best suits their needs) and clinic-facing resources (e.g., work flow templates, provider educational materials, insurance flowsheets, visit-type protocols) would best serve the needs of the clinics. We will also establish and consult with a Stakeholder Advisory Board to discuss the HCD, brainstorm strategies to reach a broader number of persons in the priority populations, and to provide ongoing feedback on the study implementation. In Phase 2 (Aims 2 & 3, years 2-5), we will launch the PrEP Blueprint in these 2 clinics and assess their implementation and impact using the RE-AIM framework (reach, effectiveness, adoption, implementation, and maintenance). We will measure these outcomes through surveys every 6 months with staff and clients; interviews with staff; and extracting data from the electronic medical records. At the end of this project, we will have an adaptable PrEP Blueprint that will contain multiple features that a variety of clinics in the US could use to increase the number of persons starting and staying on PrEP.
