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Behavioral Economics and Implementation Research to Reduce Cardiovascular Risk in HIV-infected Adults

Award Number: U01HL142104
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: COOPERATIVE AGREEMENT
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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ABSTRACT Cardiovascular disease (CVD) is a major cause of morbidity among people living with HIV (PLWH). Evidence-based statin therapy is highly effective at reducing cardiovascular risk but is under- prescribed for PLWH due to provider- and patient-level barriers. Potential provider-level barriers include misconceptions about potential side effects, inadequate knowledge of guideline recommendations, and concerns about patient adherence. Patient-level barriers to new prescription uptake often relate to concerns about side effects and uncertainty about benefits. Implementation science research suggests that barriers to implementation of evidence-based practices can occur at all levels of an organization, including at the leadership, provider, and patient levels, and that barriers at each level must be addressed for successful implementation to occur. We, therefore, propose a multi-level intervention to increase evidence-based statin prescribing by addressing barriers at these levels using the Consolidated Framework for Implementation Research. Following a qualitative phase to inform and tailor the intervention's educational component, we will implement (1) tailored education at the leadership, provider, and patient levels, and (2) provider peer comparisons. To educate leadership, specifically medical directors, we will provide a brief, in-person “peer champion”-led educational module about CVD risk in PLWH and evidence-based statin use. Patients will receive pamphlets about CVD and communication strategies with providers. A behavioral economics peer comparison strategy, to be implemented six months after the first intervention component, will be email- based and compare each physician's rate of provision of statin therapy relative to top-performing physicians caring for PLWH. In partnership with the Los Angeles County Ambulatory Care Network and community clinics (N=11 clinics), we will use a stepped-wedge cluster randomized trial design to pursue these aims: Aim 1: Assess knowledge about and barriers to statin prescribing among clinic leadership, providers, and PLWH and adapt the intervention's education intervention to address barriers at each level. Aims 2a and 2b: Determine effectiveness of the (2a) education intervention and (2b) peer comparison intervention on adoption (outcome is providers' prescribing rates) of evidence-based statin therapy. Aims 3a, 3b, and 3c: Assess implementation outcomes, including (3a) changes in provider acceptability of statin prescribing for PLWH; (3b) provider acceptability of the education and peer comparison interventions; and (3c) cost of implementing the education and peer comparison.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2023 ( Subtotal = $0 )
2023	2021	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	4	4/21/2023	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2022 ( Subtotal = $0 )
2022	2021	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	4	12/17/2021	NON-COMPETING CONTINUATION	$0
2022	2021	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90024	LOS ANGELES	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	001	4	6/7/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2021 ( Subtotal = $625,027 )
2021	2021	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90095	LOS ANGELES	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	001	4	5/26/2021	NON-COMPETING CONTINUATION	$625,027
2021	2020	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90095	LOS ANGELES	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	3	3/1/2021	NON-COMPETING CONTINUATION	$0
														Subtotal = $625,027

Issue Date FY: 2020 ( Subtotal = $671,825 )
2020	2020	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90095	LOS ANGELES	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	003	3	5/11/2020	NON-COMPETING CONTINUATION	$671,825
2020	2019	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90095	LOS ANGELES	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	002	2	4/27/2020	NON-COMPETING CONTINUATION	$0
2020	2019	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90095	LOS ANGELES	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	001	2	2/27/2020	NON-COMPETING CONTINUATION	$0
2020	2019	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90095	LOS ANGELES	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	2	12/20/2019	NON-COMPETING CONTINUATION	$0
														Subtotal = $671,825

Issue Date FY: 2019 ( Subtotal = $644,756 )
2019	2019	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90095	LOS ANGELES	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	2	7/16/2019	NON-COMPETING CONTINUATION	$644,756
														Subtotal = $644,756

Issue Date FY: 2018 ( Subtotal = $709,668 )
2018	2018	UNIVERSITY OF CALIFORNIA, LOS ANGELES	10889 WILSHIRE BLVD STE 700	LOS ANGELES	CA	90095	LOS ANGELES	USA	Translation and Implementation Science Research for Heart, Lung, Blood Diseases, and Sleep Disorders	000	1	5/27/2018	NEW	$709,668
														Subtotal = $709,668

Grand Total All Awards = $2,651,276

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Behavioral Economics and Implementation Research to Reduce Cardiovascular Risk in HIV-infected Adults

Award Number: U01HL142104

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: COOPERATIVE AGREEMENT

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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